Kite subcutaneous pedicle flap design in postoperative defect repair of nasal skin cancer based on partition and blood supply / 中华医学美学美容杂志

Objective:To investigate the clinical effect of repairing postoperative nasal skin cancer defect with subcutaneous pedicle flap based on partition and blood supply.Methods:From March 2018 to September 2020, 39 patients with skin cancer (basal cell carcinoma, Bowen′s disease, squamous cell carcinoma and malignant melanoma in situ) were repaired with kites subcutaneous pedicle flap after extensive resection.Results:Thirty-nine patients were treated with parafasal kite flaps, including 44 cases. The donor sites of the flap were nasal tip in 4 cases, bilateral alar in 7 cases, bilateral nasolabial sulcus in 19 cases, bilateral parasinal in 12 cases and interglabellar in 2 cases. There were no serious complications such as necrosis, hematoma or infection. During the follow-up period of 6 to 24 months, 2 patients complained of occasional tingling in the surgical area, 1 complained of occasional pruritus, and 1 patient had local recurrence of squamous cell carcinoma and underwent surgery again. The scar was evaluated 6 months after surgery, and the scores of Vancouver scar scale and visual analogue scale were 2.42±1.04 and 7.83±1.21, respectively. The skin color of the operation area was similar to that of the surrounding skin without obvious local strain deformation.Conclusions:The subcutaneous pedicle flap designed by considering the nasal division and blood supply has a high survival rate, fewer complications and small local appearance deformation, which is worthy of popularization and application.

Dilemma and breakthrough of acupuncture-moxibustion department under the situation of rapid expansion of hospital / 中国针灸

Under the situation of the rapid expansion of hospital, the dilemma of acupuncture-moxibustion department, as well as the relevant solutions are explored. The main reasons for the shrinking situation of the service in acupuncture-moxibustion department include: the disease-based department division trends to divert many diseases suitably treated in acupuncture-moxibustion department; the environment pursuing economic benefits restricts the development of acupuncture-moxibustion therapy characterized by "simple and low-cost operation". There are three important approaches for breaking through the dilemma of acupuncture and moxibustion therapy. First, modifying the traditional service mode as waiting for patients in acupuncture-moxibustion department and promoting acupuncture and moxibustion technology to be adopted in other departments rather than limited only in acupuncture-moxibustion department. Second, increasing the charges of acupuncture and moxibustion technology rationally. Third, positioning accurately the role of acupuncture and moxibustion technology in health services based on its own characteristics and advantages and promoting it in community medical institutions. All of these solutions require the guidance of supporting policies.

Clinicopathological features of NTRK3 gene rearrangement papillary thyroid carcinoma / 中华病理学杂志

Objective: To investigate the clinicopathological features and differential diagnosis of NTRK3 gene rearrangement thyroid papillary carcinoma (PTC). Methods: The PTC cases without BRAF V600E mutation were collected at Fujian Provincial Hospital South Branch from January 2015 to January 2020. The cases of NTRK3 gene rearrangement PTC were examined using immunohistochemistry and fluorescence in situ hybridization (FISH). The clinical data, histopathological characteristics, immunohistochemical features and molecular pathological changes were retrospectively analyzed. Data from the TCGA PTC dataset and the literature were also studied. Results: A total of 3 PTC cases harboring NTRK3 gene rearrangement were confirmed. All the patients were female, aged from 26,49,34 years. Histologically, two of them demonstrated a multinodular growth pattern. Only one case showed prominent follicular growth pattern; the other two tumors showed a mixture of follicular, papillary and solid growth patterns. All tumors showed a typical PTC nuclear manifestation, with some nuclear pleomorphism, vacuolated foci and oncocytic features. The characteristic formation of glomeruloid follicular foci was present in two cases which also showed psammoma bodies, and tumoral capsular or angiolymphatic invasion. The background thyroid parenchyma showed chronic lymphocytic thyroiditis. Mitotic rates were low, and no cases had any tumor necrosis. The pan-TRK and TTF1 testing was both positive in 3 cases, while S-100 and mammaglobin were both negative in them. FISH studies confirmed the NTRK3 gene rearrangement in all 3 cases. Studies on the TCGA datasets and literature revealed similar findings. Conclusions: NTRK3 gene rearrangement PTC is rare. It may be easily misdiagnosed due to the lack of histological and clinicopathological characteristics. Molecular studies such as pan-TRK immunostaining, FISH and even next-generation sequencing are needed to confirm the diagnosis. Immunohistochemistry of pan-TRK performed in the PTC cases without BRAF V600E mutation can be used as a good rapid-screening tool. With the emergence of pan-cancer tyrosine receptor kinase inhibitors, proper diagnosis of these tumors can help determine appropriate treatments and improve their outcomes.

Chinese Medicine Meets Conventional Medicine in Targeting COVID-19 Pathophysiology, Complications and Comorbidities / 中国结合医学杂志

OBJECTIVE@#To investigate how the National Health Commission of China (NHCC)-recommended Chinese medicines (CMs) modulate the major maladjustments of coronavirus disease 2019 (COVID-19), particularly the clinically observed complications and comorbidities.@*METHODS@#By focusing on the potent targets in common with the conventional medicines, we investigated the mechanisms of 11 NHCC-recommended CMs in the modulation of the major COVID-19 pathophysiology (hyperinflammations, viral replication), complications (pain, headache) and comorbidities (hypertension, obesity, diabetes). The constituent herbs of these CMs and their chemical ingredients were from the Traditional Chinese Medicine Information Database. The experimentally-determined targets and the activity values of the chemical ingredients of these CMs were from the Natural Product Activity and Species Source Database. The approved and clinical trial drugs against these targets were searched from the Therapeutic Target Database and DrugBank Database. Pathways of the targets was obtained from Kyoto Encyclopedia of Genes and Genomes and additional literature search.@*RESULTS@#Overall, 9 CMs modulated 6 targets discovered by the COVID-19 target discovery studies, 8 and 11 CMs modulated 8 and 6 targets of the approved or clinical trial drugs for the treatment of the major COVID-19 complications and comorbidities, respectively.@*CONCLUSION@#The coordinated actions of each NHCC-recommended CM against a few targets of the major COVID-19 pathophysiology, complications and comorbidities, partly have common mechanisms with the conventional medicines.

Characteristics and related factors of plantar pressure in the chronic ankle instability individuals / 北京大学学报(医学版)

OBJECTIVE@#To analyze characteristics and related factors of the plantar pressure during the level walking and single leg standing in the chronic ankle instability (CAI) individuals.@*METHODS@#From April 2019, 75 CAI individuals and 40 healthy individuals were enrolled in this study. Both of the static and dynamic plantar pressure were measured during six times level walking and three times single leg standing testing. The data including peak force, time to peak force in various foot contact areas and the time to boundary (TTB) and velocity of center of pressure (COP) were measured and compared between the affected side and the unaffected side and between the CAI cases and the healthy individuals. The correlations between the plantar pressure and the gender, Beighton score, affected side and body mass index (BMI) were analyzed.@*RESULTS@#The characteristics of plantar pressure distribution in the CAI individuals included: (1) During the level walking, the affected side showed the similar pressure contribution as the unaffected side (P>0.05). While compared with healthy individuals, there was a significantly higher peak force in the 5th metatarsal area (t=-3.86, P=0.03) of the affected side, lower peak force in the 1st (t=2.99, P=0.02), 2nd metatarsal head areas (t=2.09, P=0.01) of the affected side, medial hindfoot areas of both sides (affected, t=2.33, P=0.01; unaffected, t=3.74, P=0.02) and toes areass of both sides (affected, t=2.23, P=0.01; unaffected, t=3.28, P=0.02) and a delay to peak force in the 4th metatarsal head area (t=3.33, P=0.01) of the affected side. (2) During the single leg standing, the CAI individuals showed significantly worse balance control in the anterior/posterior direction (P < 0.05) and lateral/medial direction (P < 0.05) compared with the healthy controls, and the affected side had more severe balance control deficit in the lateral/medial direction (P < 0.05). (3) The women (P < 0.05) and the individuals with higher Beighton scores (P < 0.05) showed worse balance control deficit in the lateral/medial direction.@*CONCLUSION@#CAI individuals showed significantly a more lateral shifted plantar distribution during the level walking compared with the healthy individuals and the tendency was worse on the affected sides, and showed worse balance control in the anterior/posterior direction and lateral/medial direction during the single leg standing. The women and those with generalized ligament laxity showed significantly worse balance control.

Internationalized background of developing modern acupuncture and moxibustion-on the reform of teaching material of / 中国针灸

This paper analyzes the severe challenges posed by the localization process in the internationalization of Chinese acupuncture and moxibustion to Chinese traditional acupuncture and moxibustion, and the ways to deal with the challenges. It is believed that the lack of deep understanding of the challenges in the process of internationalization of acupuncture and moxibustion is mainly due to the lack of knowledge structure of acupuncture and moxibustion, and the innovation of acupuncture and moxibustion teaching materials is the basis of effectively adjusting the knowledge structure. The direction of the reform of acupuncture and moxibustion teaching materials should separate the modern version of acupuncture and moxibustion that conforms to the nature of science and teach it in parallel with the traditional version of acupuncture and moxibustion. The development of modern acupuncture and moxibustion in line with the nature of science is not only an urgent need to meet the challenges of western acupuncture and moxibustion, but also an internal requirement for the development of acupuncture and moxibustion itself.

Localization of Chinese acupuncture-moxibustion in the United States: the openness of modern acupuncture-moxibustion system / 中国针灸

The internationalization of Chinese acupuncture-moxibustion is inevitably accompanied by the localization of acupuncture-moxibustion. The localization of acupuncture-moxibustion will inevitably promote the diversified development of acupuncture-moxibustion technique and theory, which fully demonstrates the openness of modern acupuncture-moxibustion. In this study, the characteristics of localization of Chinese acupuncture-moxibustion in the United States are explored and studied from the following aspects: legal adjustment, technical adjustment, educational adjustment, service adjustment and theoretical adjustment.

An analysis on correlation between acupoint and target organs of acupuncture-moxibustion from the perspective of modern medical sciences / 针刺研究

The segmental neuronal connection plays an important role in acupoint-target organ specific correlation. The acupoint-target organ correlation includes acupoint-visceral correlation and acupoint-somatic correlation. The acupoint-viscera correlation involves both the primary central (spinal cord) mechanism and the peripheral (dorsal root ganglion, DRG) mechanism implemented by segmental nerve reflex via the spinal cord and axonal reflex via DRG respectively, while the acupoint-somatic correlation mainly involves the axonal reflex.

Inclusivity and innovation in modern acupuncture and moxibustion: breakthroughs of / 中国针灸

As a work of modern acupuncture and moxibustion, the discusses various key issues in the field of acupuncture and moxibustion, such as the existing problems of acupuncture and moxibustion, the deconstruction of traditional acupuncture and moxibustion, the cultural problems of acupuncture and moxibustion, the construction of modern acupuncture and moxibustion system, the significance of western acupuncture and moxibustion, the value of 's acupuncture and moxibustion, the problems of systematic acupuncture and moxibustion, which has showed inclusivity and innovation of modern acupuncture and moxibustion.

Correlation of visfatin and endothelin with subclinical hypothyroidism in patients with cerebral infarction / 医学研究生学报

Objective Few studies are reported on the relationship of subclinical hypothyroidism ( SCHT ) with visfatin and endothelin .This study aimed to investigate their relationship in patients with cerebral infarction . Methods A total of 200 cerebral in-farction patients treated in The Second Affiliated Hospital of Hainan Medical University from January 2011 to July 2017 were divided in-to a control ( with normal thyroid function , n=40 ) , a mild SCHT ( with thyroid-stimulating hormone TSH <10 mIU/L, normal free triiodothyronine FT3 and normal free thyroxine FT4, n=60), a se-vere SCHT (with TSH≥10 mIU/L, normal FT3 and normal FT4, n=60) , and a clinical hypothyroidism ( CHT ) group ( with TSH ≥4 mIU/L, decreased FT3 and decreased FT4, n=40).The mild SCHT patients were subdivided into medication group A and non-medication group A, and the severe SCHT patients into medication group B and non-medication group B, 30 in each group, those in the medica-tion groups A and B treated by routine therapy plus oral levothyrocine , and those in the non-medication groups A and B by routine ther-apy only.We recorded the age, gender, body mass index, blood pressure, blood glucose, blood lipid, and thyroid function of the pa-tients, and compared the levels of visfatin and endothelin among different groups . Results The level of visfatin was significantly ele-vated in the severe SCHT and CHT groups as compared with the controls ([46.3±10.1] and [49.5±13.6] vs [40.2±9.7] ng/mL, P<0.05), and so was it in medication group B as compared with non-medication group B at 6 months after treatment ([42.9±6.4] vs [39.3±5.5] ng/mL, P<0.05). Conclusion Visfatin is closely related with thyroid hormone in cerebral infarction patients with se -vere subclinical hypothyroidism .Examination of thyroid function is necessary for cerebral infarction patients for the sake of early detec -tion of severe subclinical hypothyroidism and timely intervention .

Correlation of visfatin and endothelin with subclinical hypothyroidism in patients with cerebral infarction / 医学研究生学报

Objective Few studies are reported on the relationship of subclinical hypothyroidism ( SCHT ) with visfatin and endothelin .This study aimed to investigate their relationship in patients with cerebral infarction . Methods A total of 200 cerebral in-farction patients treated in The Second Affiliated Hospital of Hainan Medical University from January 2011 to July 2017 were divided in-to a control ( with normal thyroid function , n=40 ) , a mild SCHT ( with thyroid-stimulating hormone TSH <10 mIU/L, normal free triiodothyronine FT3 and normal free thyroxine FT4, n=60), a se-vere SCHT (with TSH≥10 mIU/L, normal FT3 and normal FT4, n=60) , and a clinical hypothyroidism ( CHT ) group ( with TSH ≥4 mIU/L, decreased FT3 and decreased FT4, n=40).The mild SCHT patients were subdivided into medication group A and non-medication group A, and the severe SCHT patients into medication group B and non-medication group B, 30 in each group, those in the medica-tion groups A and B treated by routine therapy plus oral levothyrocine , and those in the non-medication groups A and B by routine ther-apy only.We recorded the age, gender, body mass index, blood pressure, blood glucose, blood lipid, and thyroid function of the pa-tients, and compared the levels of visfatin and endothelin among different groups . Results The level of visfatin was significantly ele-vated in the severe SCHT and CHT groups as compared with the controls ([46.3±10.1] and [49.5±13.6] vs [40.2±9.7] ng/mL, P<0.05), and so was it in medication group B as compared with non-medication group B at 6 months after treatment ([42.9±6.4] vs [39.3±5.5] ng/mL, P<0.05). Conclusion Visfatin is closely related with thyroid hormone in cerebral infarction patients with se -vere subclinical hypothyroidism .Examination of thyroid function is necessary for cerebral infarction patients for the sake of early detec -tion of severe subclinical hypothyroidism and timely intervention .

“I'm healthy, I don't have pain”- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population

BACKGROUND: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ≥ 85% own homes; public rental flats are reserved for those with low-income. METHODS: Chronic pain was defined as pain ≥ 3 months. From 2009−2014, residents aged 40−60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves. RESULTS: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36−3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25−3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18−4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34−5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94−6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of “major illness”; screening as a search for answers to pain; and labelling pain as an end in itself. CONCLUSIONS: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.

Analysis of clinical evaluation of response to treatment of Parkinson's disease with integrated Chinese and Western medicine therapy / 中国结合医学杂志

<p><b>OBJECTIVE</b>To analyze the clinical evaluation of Parkinson's disease (PD) patients receiving integrated Chinese and Western medicine therapy.</p><p><b>METHODS</b>One hundred and twenty patients were enrolled and randomly allocated to a control group or treatment group. Patients in the two groups received placebo and Bushen Huoxue Granule (, BHG), respectively. Both groups received baseline levodopa and benserazide (Madopar). The effects of treatment were assessed monthly during the 9-month treatment. Means of evaluation included Unified PD Rating Scale (UPDRS) scores (II and III), sleep scale score, 10 m turn back test (getting up time, 10 m×2 times, and turning time), timing motor test (TMT)-left and TMT-right, which were treated as the dependent variables; and age, sex, duration of PD, Hoehn and Yahr (H-Y) stage and Madopar dosage of admitted PD patients were as the independent variables. Multiple linear regression was used to analyze these factors.</p><p><b>RESULTS</b>H-Y stage significantly affected UPDRS II score, UPDRS III score, and getting up time (P<0.01). Madopar dosage and H-Y stage significantly affected the 10 m×2 times (P<0.05 or <0.01). Madopar dosage significantly affected the sleep scale score (P<0.05). There were also significant correlations between age and TMT-left or TMT-right (P<0.01), and duration of PD and TMT-right (P<0.05).</p><p><b>CONCLUSIONS</b>The six assessed means of clinical evaluation (including UPDRS II and UPDRS III scores, sleep scale score, getting up time, 10 m×2 times, and turning time) are sensitive indexes in all PD patients. H-Y stage and Madopar dosage are the major factors influencing means of clinical assessment of PD treatment.</p>

Plague surveillance and control in Longlin county Guangxi from 2000 to 2009 / 中国地方病学杂志

Objective To analyze the outcome of surveillance results on plague and to provide the evidences for the policy making in Longlin county Guangxi. Methods The epidemic data and the surveillance results of plague were analyzed and assessed with epidemiology methods in Longlin county Guangxi from 2000 to 2009, and the density of rodents, the rodents infected with flea, flea index and other indicators were calculated. Regional composition of the rats and fleas were analyzed. Results A totally of 4829 rats were captured and 4737 fleas were collected in the past 10 years, Rattus Flavipestus(81.92%,3956/4829) and Xenopsylla Cheopis (79.04%,3744/4737) were dominant species. The annual average density of rodents, the rodents infected with flea, index of flea were 3.30%(4829/146 206), 27.99%(1351/4827) and 0.98(4737/4827), respectively. A totally of 4792 rats were examined and 10 strains Yersinia Pestis were isolated. Indirect hemorrhagic assessed(IHA) was used to test the F1 antibody against plague in the blood serum of the rats and indicator animals, and 3 positive rats and 24 positive animals were found, respectively. Twenty seven natural villages in 3 towns had been involved in the plague. Conclusions The plague foci exists in Longlin county of Guangxi province. The plague foci in the areas have the same feature with the plague foci of Rattus Flavipectus. There is a potential risk for plague in this region, we should improve the quality of surveillance, increase indicator animals of the plague, and try to apply new surveillance method.

Preliminary comparison on the time-effect rule of pain-relieving in the treatment of moderate dysmenorrhea between acupuncture on single-point and acupuncture on multi-point / 中国针灸

<p><b>OBJECTIVE</b>To compare the time-effect rule of pain-relieving in moderate dysmenorrhea in the treatment between acupuncture on single-point and acupuncture on multi-point so as to determine the best time of needle retaining on single-point and multi-point as well as provide the reference evidences of acupuncture frequency in the treatment.</p><p><b>METHODS</b>Sixty-three cases of moderate dysmenorrhea were randomized into a single-point group (31 cases) and a multi-point group (32 cases). During the attack of dysmenorrhea, in single-point group, Shiqizhui (EX-B 8) was punctured; in multi-point group, Shiqizhui (EX-B 8), Diji (SP 8), Ciliao (BL 32) and Sanyinjiao (SP 6) were punctured and the needles were retained for 30 min. Visual Analogue Scale (VAS) values were recorded in the immediate time before acupuncture, in 5 min, 10 min, 20 min and 30 min after needle insertion, as well as in 30 min, 60 min and 120 min after needle withdrawal separately.</p><p><b>RESULTS</b>After needling, analgesia was generated rapidly in either group. During 30 min of needle retaining, analgesia was enhanced persistently till needle withdrawal in either group. In 10 min after needle insertion, the immediate analgesia in multi-point group was superior obviously to single-point group (P < 0.05) and this effect was maintained in 2 h after needle withdrawal. In 30 min after needle withdrawal, acupuncture analgesia was declined to the maximum.</p><p><b>CONCLUSION</b>Either single-point acupuncture at Shiqizhui (EX-B 8) or multi-point acupuncture at Shiqizhui (EX-B 8) and other acupoints has apparent immediate analgesia on primary dysmenorrhea of moderate degree, but the effect of multi-point acupuncture is better than that of acupuncture at Shiqizhui (EX-B 8). No matter with acupuncture at Shiqizhui (EX-B 8) or at multi-point, the time of needle retaining should not be shorten than 30 min. It is suitable to give acupuncture, twice per day for the patients with moderate and persistent pain.</p>

Observation on immediate analgesic effect of acupuncture at Shiqizhui (EX-B 8) only or multi-acupoints in patients with dysmenorrhea: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the different therapeutic effect between acupuncture at Shiqizhui (EX-B 8) only and multi acupoints on dysmenorrhea.</p><p><b>METHODS</b>Thirty eight cases were randomly divided into a single acupoint group and a multi-acupoints group, 19 cases in each group. The single acupoint group was treated by acupuncture at Shiqizhui (EX-B 8) only, and the multi-acupoints group by acupuncture at Shiqizhui (EX-B 8), Sanyinjiao (SP 6), Diji (SP 8), Ciliao (BL 32). They were all treated from the first day when sudden intense pain occurs, one time each day, for 3 days in each menstrual cycle, the treatment of three menstrual cycles. The therapeutic effect and Visual Analogue Scale (VAS) were compared and the score of general frequency and severity of dysmenorrhea by using Cox Menstrual Symptom Scale (CMSS) were evaluated.</p><p><b>RESULTS</b>The cured rate was 68.4% (13/19) and the effective rate was 31.6% (6/19) in the single acupoint group, being similar to 78.9% (15/19) and 21.1% (4/19) in the multi-acupoints group (P > 0.05). VAS and the scores of general frequency and severity of dysmenorrhea were all significantly decreased after treatment in both groups (all P < 0.001), with no significant difference between the two groups (all P > 0.05).</p><p><b>CONCLUSION</b>Acupuncture at Shiqizhui (EX-B 8) only can be as effective as selecting multi-acupoints to cure essential dysmenorrhea.</p>

Clinical study on the treatment of primary dysmenorrhea with preconditioning acupuncture / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of preconditioning acupuncture (PA) on the treatment of primary dysmenorrhea.</p><p><b>METHODS</b>Eighty patients suffered from primary dysmenorrhea were randomly assigned on the ratio of 1:1:2 into three groups, 20 in Group A, 20 in Group B, and 40 in Group C. Group A and B were treated with PA and immediate acupuncture (IA), respectively, while Group C received no acupuncture treatment and be taken as a blank control. The treatment was lasted for three menstrual cycles. The therapeutic effects were observed and compared.</p><p><b>RESULTS</b>Comparing the scores of the symptoms in the different groups, the therapeutic effect in different groups showed that the symptom scores in Group A at the second and third cycle of treatment, as well as at the first and third cycle of follow-up, were significantly lower than the scores in Group B, respectively (P<0.05 or P<0.01), and the duration of symptoms was shorter in Group A than in Group B at the third cycle of treatment and the first and third cycle of follow-up (P<0.05). Symptom scores in Groups A and B in the treatment and follow-up periods were all lowered as compared to those before treatment (P<0.01), and the scores were also lower than those in Group C measured at corresponding times (P<0.01).</p><p><b>CONCLUSION</b>The therapeutic effect of PA, either the short-term or the long-term effect, was superior to that of IA in treating dysmenorrhea.</p>

Observation on the fluid resuscitation and the change in blood sodium of severely burned patients in the early stage / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the necessary amount of fluid consisting of electrolyte and colloid, the ratio of electrolyte and colloid used, and the change of blood sodium during early resuscitation in severely burned patients.</p><p><b>METHODS</b>Sixty-seven patients with total burn surface area (TBSA) equal to or over 70% and full-thickness area equal to or over 50%TBSA, hospitalized from March 2004 to March 2009, were resuscitated with fluid. The infusion amount of electrolyte, colloid, and water, and urinary output of patients at post injury hour (PIH) 24, 48, and 72 were analyzed retrospectively. The variation in blood sodium and fluid infusion at different time points was recorded. Data were processed with SPSS 13.0 software.</p><p><b>RESULTS</b>Among the 67 patients, hyponatremia occurred in 9 cases, hypernatremia occurred in 5 cases, and 53 patients had normal blood sodium level. The urinary output of patients within PIH 72 was above 70 mL/h. K value was calculated through the formula: actual total infusion amount of electrolyte and colloid (mL) = burn area (%TBSA) x body weight (kg) x K. In the first 24 PIH, K value was about 1.7, and the ratio of electrolyte and colloid was 1.4. In the second 24 PIH, K value was about 1.3 with electrolyte and colloid ratio 1.6. K value in the third 24 PIH was about 0.9 with electrolyte and colloid ratio 2.0.</p><p><b>CONCLUSIONS</b>The actual amount of resuscitation fluid is slightly larger than that calculated from traditional formula during the early stage in severely burned patients. The amount of electrolytes and the proportion of electrolyte and colloid will influence blood sodium level of patients.</p>

Therapeutic effect of vacuum-assisted closure technology on infected explosion wound of pig / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of vacuum-assisted closure (V. A. C.) technology in the treatment of infected wound of skin and soft tissue as a result of explosion injury in pig.</p><p><b>METHODS</b>Sixteen explosion wounds were established by electric detonators on the shoulders and hips on both sides of 4 small white domestic pigs ,and they were divided into A group [(without treatment and infection occurred on 1-2 post burn day (PBD), then treated with vaseline gauze on 3 (PBD)], and B group (with the same treatment as in A group, except for treatment of vacuum assisted closure (V. A. C) with pressure of - 15 kPa after 3 PBD). The data of wound depth, wound area, wound healing time were collected and analyzed at 3 PAD and 1, 3, 6, 9, 14, 19, 24 days after treatment. Specimens from wounds were collected for histopathology observation, including also cell proliferation index, the number of vascular endothelial cells, the activity of myeloperoxidase (MPO) and the number of bacteria.</p><p><b>RESULTS</b>Compared with those in A group on land 3 days after treatment, wound area, wound depth were not enlarged or deepened in B group, while the number of inflammatory cells, vascular endothelial cells, proliferative cells were increased, the activity of MPO was enhanced and the number of bacteria was decreased. There were obvious differences between two groups in following indices: wound area ,wound depth, the number of vascular endothelial cells and bacteria during 1 to 19 days after treatment (P < 0.01)), the number of cell proliferation from 1 - 9 days after treatment (P < 0.01)), and the activity of MPO on 3, 6 days after treatment (P < 0. 01). The wound healing time was (32.8 +/- 1.6) d in A group, which was longer than that in B group (25.8 +/- 1.0 d, P < 0.01).</p><p><b>CONCLUSION</b>Compared with conventional dressing change, V. A. C can decrease bacteria load, lessen secondary necrosis, prompt the inflammatory response, accelerate the formation of granulation tissue, shorten wound healing time in infectious wound of porcine skin and soft tissue resulted from explosion injury.</p>

The influence of vacuum-assisted drainage on the growth of capillaries in the wound produced by explosion in pig / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of vacuum-assisted closure (VAC) technique on the growth of capillaries in the wound of the pig produced by explosion.</p><p><b>METHODS</b>Four small white pigs were inflicted with 16 explosion wounds [(7.3 +/- 1.0) cm2 in area] on both sides of the buttocks, shoulders and hips by detonation of a specific type of explosive, and the wounds were randomly divided into 2 groups, i. e, control (C, with conventional treatment from 2 post-injury day (PID) on and treatment (T, with VAC treatment after debridement from 2 PID on) groups, with 8 wounds in each group. Wound tissues of 2mm x 2mm x 2mm in size were harvested for pathological examination before treatment and on 1 and 3 post-treatment day (PTU). The differentiation of adventitial cells were examined with light microscope, and the pixel value of desmin positive particles and the luminal area of newly formed capillaries were assessed with Image C software.</p><p><b>RESULTS</b>Most of vessels in the wound of both groups were in elliptic shape when observed in longitudinal section. In C group, few newly formed capillaries vessels with lack of pericytes were observed before treatment and on 1, 3 PTD, then the number began to increase on 6 PTD. In T group, the number of newly formed capillaries with pericytes was increased on 1 PTD, and it continued to increase thereafter. The pixel values of desmin positive particles in C group on 1, 3, and 6 PTD were (91 +/- 54), (199 +/- 85), and (1552 +/- 298), respectively, which were obviously higher than those in T group [(2569 +/- 330), (3984 +/- 377), (9611 +/- 960), P < 0.01]. The area of vessel lumen in C group was (59 +/- 36), (250 +/- 70), and (938 +/- 287) microm2, respectively on 1, 3, and 6 PTD, which was also smaller than those in T group [(818 +/- 234), (4518 +/- 1080), and (9058 +/- 1656) microm2, P < 0.01].</p><p><b>CONCLUSION</b>Compared with conventional therapy, VAC can not only accelerate the formation of new capillaries, but also enhance the differentiation of pericytes and the process of enwrapping them around the vessels, and increase the luminal area of newly formed capillaries.</p>