Clinical effects of in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage in the treatment of hypertrophic scar in non-functional sites after burns / 中华烧伤杂志

Objective: To investigate the clinical effects of in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage in the treatment of hypertrophic scar in non-functional sites after burns. Methods: A retrospective observational study was used. From June 2017 to June 2019, 33 patients (24 males and 9 females, aged 8-50 years) who met the inclusion criteria with hypertrophic scars in non-functional sites outside the face after burns were treated in General Hospital of TISCO (the Sixth Hospital of Shanxi Medical University). All patients underwent scalp transplantation after perforation of retained split scar matrix in situ (with scar thinning area of 90-500 cm2), and then the vacuum sealing drainage was performed. The hematoma and infection of wounds were observed on the 7th day after operation. At the same time, the survival rate of skin grafting was observed and calculated. The flatness and thickness of the scar in the operative area were observed in 12 months after operation, and the itching and pain of the patients were recorded. Vancouver Scar Scale was used to score the scar of patients before operation and at 3, 6 and 12 months after operation. The healing time and hair growth of donor site were observed. Data were statistically analyzed with repeated analysis of variance, paired sample t test and bonferroni correction. Results: On the 7th day after operation, local subcutaneous hematoma appeared in the wound of 2 patients, which healed after dressing change; no infection occurred. On the 7th day after operation, the survival rate of skin grafting of patients was 94.6%-99.0%(96.8±1.2)%. Scar flatness was well, the thickness of scar was not significantly higher than that of normal skin in 12 months after operation, and the symptoms of itching pain of patients disappeared or significantly relieved. Vancouver Scar Scale scores of patients before operation and at 3, 6, and 12 months after operation were 12.1±2.8, 8.5±1.5, 7.6±1.6, 6.7±1.3, respectively, and the scores of 3, 6, and 12 months after operation were all significantly lower than that before operation (with t values of 4.48, 4.06, and 3.97, respectively, P<0.01). All the donor sites of the head healed well in 4-7 days after operation. By 3-6 months after operation, all patients had good hair growth in the donor site and achieved no scar healing. Conclusions: The treatment of hypertrophic scar in non-functional sites outside the face after burns by in situ perforation of preserved split scar matrix in combination with scalp transplantation and vacuum sealing drainage can effectively improve the appearance of hypertrophic scar in non-functional areas after burn and reduce its degree of hyperplasia, with scar-free donor site healing.

Influence of rhubarb on gastrointestinal motility and intestinal mucosal barrier in patients with severe burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the influence of rhubarb on gastrointestinal motility and intestinal mucosal barrier in patients with severe burn.</p><p><b>METHODS</b>Thirty patients with severe burn admitted to our burn wards within 48 hours after burn injury from December 2009 to December 2010 were divided into therapeutic group (T, treated with 10 g rhubarb by nasal feeding and 5 g L-glutamine by oral administration beginning from 6 hours after admission, three times per day, and also given enteral nutrition beginning from 24 hours after admission, n = 16) and control group (C, received the same treatment as used in T group but without rhubarb, n = 14) according to the random number table. Gastrointestinal function indexes including restoration of bowel sound within 24 hours, abdominal distension, tolerance to enteral nutrition, and defecation were observed after treatment. The serum samples were harvested on post burn day (PBD) 3, 7, 14 for determination of the levels of gastrin (GAS) by radioimmunoassay, motilin (MTL) by enzyme-linked immunosorbent assay, diamine oxidase (DAO) by enzyme spectrophotometry, and endotoxin (ET) by kinetic turbidimetric assay with TAL. Data were processed with t test and chi-square test.</p><p><b>RESULTS</b>Compared with those in C group, the numbers of patients with restoration of bowel sound within 24 hours and tolerance to enteral nutrition in T group were increased (with chi2 value respectively 5.01, 4.84, P values all below 0.05), the number of patients with abdominal distension was decreased (chi2 = 4.84, P = 0.025). Compared with those of C group, defecation time was earlier, number of bowel movement was increased with soft feces in patients of T group. The serum levels of GAS in T group on PBD 3, 7, 14 [ (92 +/- 26), (95 +/- 16), (98 +/- 18) ng/L] were significantly higher than those in C group [(80 +/- 15), (75 +/- 17), (79 +/- 13) ng/L, with t value respectively 15.352, 22.951, 19.263, P values all below 0.01]. The serum levels of MTL in T group on PBD 3, 7, 14 [(246 +/- 80), (299 +/- 76), (300 +/- 100) ng/L] were significantly higher than those in C group [(189 +/- 44), (203 +/- 64), (200 +/- 67) ng/L, with t value respectively 14.173, 19.294, 26.298, P values all below 0.01]. The serum levels of ET in T group on PBD 3, 7, 14 [(0.398 +/- 0.035), (0.373 +/- 0.005), (0.238 +/- 0.019) EU/mL] were significantly lower than those in C group [(0.493 +/- 0.043), (0.501 +/- 0.045), (0.423 +/- 0.099) EU/mL, with t value respectively 6.213, 9.153, 15.134, P < 0.05 or P < 0.01]. The serum levels of DAO in T group on PBD 3, 7 [ (3.0 +/- 0.4), (2.9 +/- 0.5) U/mL] were significantly lower than those in C group [(3.9 +/- 0.5), (3.6 +/- 0.6) U/mL, with t value respectively 3.982, 4.236, P values all below 0.05], and there was no obvious difference between T and C groups on PBD 14 (t = 1.762, P > 0.05).</p><p><b>CONCLUSIONS</b>Rhubarb can protect intestinal mucosal barrier in patients with severe burn through increasing secretion of gastrointestinal hormones and promoting restoration of gastrointestinal motility.</p>

Spatial organization of neurons, astrocytes and vessels in rat brain / 中南大学学报(医学版)

OBJECTIVE@#To demonstrate the spatial organization of neurons, astrocytes and vessels in rat brain.@*METHODS@#Cerebral vascular was shown by vivi-perfusion with ink. Glial fibrillary acidic protein (GFAP) immunohistochemistry and nissl's staining were performed on the serial sections of frozen brain tissues.@*RESULTS@#Astracytes distributed along the branches of blood vessels, and neurons in the region of the relatively rich blood vessels. Neurons and astrocytes presented regional distribution.@*CONCLUSION@#This method can well indicate the spatial organization of neurovascular unit, the regional differences in the distribution may be related to physical activities and the corresponding adjustment function.