Clinical study of tangential excision within 24 hours after burn with massive deepⅡdegree in treatment for eld-erly patients / 局解手术学杂志

Objective To observe the clinical efficacy and inflammation of tangential excision within 24 hours after burn with massive deep Ⅱdegree burn wounds for elderly patients. Methods From Jan. 2010 to Dec. 2013, a total of 82 elderly patients with massive deepⅡdegree burn wounds were divided into the observation group ( giveing tangential excision within 24 hours after burn) and the control group ( giveing tangential excision within 3~5 d after burn) according the time of tangential excision treatment. The amount of infused fluid, u-rine, levels of serum inflammatory factors, survival rate of skin grafts, wound healing time, hospitalization time and the complications were compared between the two groups. Results There was no significant difference in the amount of infused fluid, plasma and urine between the two groups in the first day and fifth day (P>0. 05). The levels of TNF-αsignificantly decreased after 3 days of therapy compared with the control group (P<0. 05). The levels of IL-6 significantly decreased and IL-10 significantly increased from the first day of therapy in the ob-servation group compared with the control group (P<0. 05). The survival rate of skin grafts in the observation group was significantly higher than that in the control group, and time of wound healing and hospitalization in the observation group was significantly shorter than that in the control group (P<0. 05). The complication rate of the observation group was 11. 1% which was significantly lower than that in the control group 29. 7% (P<0. 05). Conclusion To treat burn with massive deepⅡdegree burn wounds for elderly patients with tangential excision within 24 hours which can effectively reduce the inflammatory, reduce wound infection and improve the success rate of skin grafting.

The influence of recombinant human growth hormones on the systemic metabolism after severe burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the influence of recombinant human growth hormones (rhGH) postburn systemic metabolism.</p><p><b>METHODS</b>Twenty-four burn patients were randomly and equally divided into treatment and control groups. Same amount of rhGH (9 U/d) or isotonic saline was injected subcutaneously to respective patients during 3 approximately 17 postburn days (PBDs). Blood samples were harvested at 3, 10 and 17 PBDs for the determination of serum growth hormone, insulin-like growth factor (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), serum proteins, plasma insulin, plasma glucagons and blood glucose, which were then compared and analyzed between two the groups.</p><p><b>RESULTS</b>The serum levels of GH, IGF-1, IGFBP-3, serum prealbumin and transferrin in rhGH treatment group were evidently higher than those in control groups at 10 and 17 PBDs (P < 0.05 approximately 0.01). But there was no obvious difference in serum albumin, plasma insulin, glucagon and blood glucose (P > 0.05).</p><p><b>CONCLUSION</b>Small dose of rhGH could promote systemic protein synthesis with no side effects on blood glucose levels.</p>

Simultaneous septorhinoplasty / 中华医学美学美容杂志

Objective To introduce a new septorhinoplastic method for twisted nose, humped nose and hawk nose as well as deviation of nasal septum, and to evaluate its operative method and effect. Methods The incision of cleft between lateral nasal cartilage and greater alar cartilage was employed in all patients. The method of unilateral mucoperiosteal flap osteotomy was used to correct nasal pyramid deformity, and swinging-door operation was performed to correct the deviation of nasal septum simultaneously. Results The operative results of 36 cases were effective and satisfactory. Postoperative follow-up ranged from one year to fifteen years. Based on the results of follow-up in the 32 cases, no recurrence and complications were found in all the cases. Conclusion This new method for septorhinoplasty avoids the detachment and move of nasal bone and nasal septum cartilage and injury of nasal mucoperiosteum, and maintains the blood supply of nasal bone and nasal septum cartilage. It corrects extero-nasal deformity as well as deviation of nasal septum. The operation is effective in nose aesthetic and ventilatory function.