Objective Endoplasmic reticulum stress (ERS) mediated apoptosis is one of the eukaryotic cellularapoptotic pathways, to investigate the potential role of ERS during myocardium apoptosis in rats with severe burninjury. Methods Sixty-four 7-week-old male Wistar rats, weighing 200-220 g, were randomly divided into 2 groups. Thirtypercentage of total body surface area full-thickness thermal injury was produced in 32 rats of burn group, while sham burn wasproduced in 32 rats of control group. The heart tissues were harvested from 8 rats in each group at 1, 4, 7, and 14 days after burnto observe the changes of myocardium ultrastructure with transmission electron microscope (TEM). Myocardium apoptosis wasdetected with TUNEL assay. The expressions of glucose regulated protein 78 (GRP 78), C/EBP-homologous protein (CHOP),and cleaved Caspase 12 in different pathways of ERS were analysed with Western blot. Results All rats survived during theexperiment. Apoptotic changes of cardiomyocytes were observed in burn group, and the apoptosis index in burn group wassignificantly higher than that in control group at each time point (P lt; 0.05), and it reached peak at 7 days after burn injury(P lt; 0.05). The expressions of myocardial GRP 78, CHOP, and cleaved Caspase 12 showed persistent elevation in burn group.The expressions of GRP 78 and cleaved Caspase 12 in burn group were significantly higher than those in control group at eachtime point (P lt; 0.05), while the expression of CHOP was higher than that in control group at the other time points (P lt; 0.05)except 1st day after burn injury. Conclusion ERS and CHOP, Caspase 12 mediated apoptotic pathway are activated inmyocardium after severe burn injury, and this may be one pathway of myocardium apoptosis.
Objective To investigate the benefit of the combined therapy for deformed fingers after burn injury by compairing with the conventionalone,and to sum up some experience. Methods From June 1999 to June 2004, 56 patients with deformed fingers entered the trial. In 28 patients of treatment group who received combined therapy(operation with postoperational systematic convalescent care, group A), there were 20 males and 8 females (14-47 years), 129 fingers of 47 hands were involved. In 28 of conventional group who received conventional therapy (the same operational principle, and self-convalescent-care with out-patient service guidance, group B), there were 17 males and 11 femals (18-51 years), 107 fingers of 42 hands were involved. Before and afterthe therapy, the finger’s motor function were assessed according to the Swansonmethod. The hand’s motor function was assessed through the Nine Hole Peg Test. Results The follow-up was 12-19 months in group A and 13-20 months in group B. The index of ankylosis (IA) of group A before therapy was82%±20%, and 45%±13% after theraphy; while the IA of group B before therapy was 78%±17%, and 52%±14% after therapy. The decreased of IA between before therapy and after therapy was 37%±15% in group A, and 26%±15% in group B, showing significant difference between the two groups (P＜0.05) . The Nine Hole Peg Test value of group A was 28.34±5.62s before therapy, and 20.73±4.25 s after therapy; while that of group B was 27.47±5.78 s before therapy, and 21.86±4.12 s after therapy. The decrease of the Nine Hole Peg Test value between before therapy and after therapy was 7.61±2.27 s in group A, and 561±294 s in group B, showing statistically significant difference (P＜0.05). Conclusion The combined therapy is more effective than the conventional one.
OBJECTIVE: To evaluate the application of skin and soft tissue expansion in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound. METHODS: From 1988, 83 cases of application of skin and soft tissue expansion were reported. In those patients with deformity due to severe burn of large area and with whole nasal defect, soft tissue expander was used under the forehead skin graft and venter frontalis, followed by reconstruction of nose with the expanded vascularized skin flap and carved cartilago costalis as nasal frame. In patients of severe deep electrical burned scalp and skull with fresh wound, skin and soft tissue expansion were used to repair the wound simultaneously with scalp burn alopecia, anesthetics and antibiotics injected into the extracapsular space of the expander in case of pain and infection. RESULTS: All of the cases were successfully treated with little pain and minimized infection. CONCLUSION: Skin and soft tissue expansion in a safe and reliable measure in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound.
Objective To observe the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), platelet 5-HT and blood platelet count, emotion and burn injury healing of patients with moderate and severe burn injury and anxiety-depression symptoms. Methods In-patients with moderate and severe burn injury were selected from 2003.4 to 2005.2 and then divided into anxiety-depression group and control group according to their anxiety-depression scores by Hamilton Rating Scale for Depression (HAMD ) and Hamilton Rating Scale for Anxiety (HAMA) 3 days after being burnt. Routine therapy was given to two groups, which lasted 1 month. Their scores of anxiety and depression and the degree of injury healing were observed, and the serum levels of TNF-α and IL-6, platelet 5-HT and blood platelet count were measured in the two groups. Results Fifty-one in-patients with moderate and severe burn injury were divided into the anxiety-depression group (24 cases) and the control group (27 cases). After 30-day treatment, the depression scores did not decrease in the anxiety-depression group (P=0.12), but the anxiety scores decreased (P=0.00). In the anxiety-depression group, the burn injury healing time was postponed (P=0.00), the serum levels of TNF-α increased (P=0.00), and the platelet 5-HT levels decreased (P=0.04) before and after treatment. Conclusion Depressive reaction occurs in patients with moderate and severe burn injury, which is a continuously negative emotion. It can lead to high levels of serum TNF-α, reduction in platelet 5-HT, and delayed burn injury healing time. Due to the limited sample size and different location of patients, there may be some bias in this conclusion. We are prepared to increase the sample size and select patients in the same region in further relevant studies.