中华烧伤与创面修复杂志

Face the challenge, create brilliance further: understanding of burn surgery confusion in our country

Jia Chiyu

2016, 32(12): 705-708. doi: 10.3760/cma.j.issn.1009-2587.2016.12.001

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Burn surgery has a glorious history in our country, but it still faces enormous challenges at present: the incidence of burn declines year by year, basic research and clinical diagnosis are more or less disjointed, national medical care and education system need to be further perfected, fusion of new technology lags behind, and army system adjustment in military hospitals is in progress, etc. We need to adjust strategies in time of peace, and prepare for challenges so as to create new splendor.

Reconstruction of perineal obliteration deformity after extensive deep burn with ilioinguinal flap

Shen Yuming, Ma Chunxu, Qin Fengjun, Wang Cheng, Du Weili, Zhang Cong

2016, 32(12): 709-713. doi: 10.3760/cma.j.issn.1009-2587.2016.12.002

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Objective To explore the effect of ilioinguinal flap on reconstruction of perineal obliteration deformity after extensive deep burn. Methods Five patients with perineal obliteration deformity after extensive deep burn were hospitalized from January 2010 to June 2015, with total burn area ranging from 35% to 55% total body surface area, depth of full-thickness burn and wound deep to bone, and course of scar from 6 months to 3 years. Scars of patients were involved in bilateral groins, inner thighs, monsveneris, sacrococcygeal region, and central area of perineum. The abduction angles of double lower limbs ranged from 30 to 65°. Anus was narrow, and defecation was difficult. After release of scar tissue in perineal region, the wound area ranged from 23 cm×12 cm to 28 cm×24 cm. For wound repair and reconstruction of anus, unilateral ilioinguinal flap was used in 3 cases. Due to large wound in two patients, bilateral ilioinguinal flap was used in one patient, and unilateral ilioinguinal flap combined with anterolateral femoral flap was used in another one patient. The area of unilateral ilioinguinal flap ranged from 23 cm×12 cm to 30 cm×20 cm, and the area of anterolateral femoral flap was 21 cm×12 cm. The abdominal donor site was closed with partial suture and partial skin grafting (harvested from split-thickness skin of autologous head or thin intermediate-thickness skin of autologous back). The femoral donor site was directly sutured. After the operation, the double lower limbs were fixed with plaster on abducent position and strictly immobilized. Results All the flaps survived after operation and the wounds healed well. During the follow-up for 6 to 12 months, the appearance of flaps were good with soft texture and no contracture. Hip joint motion was good, and abduction angles of double lower limbs ranged from 110 to 135°. The appearance of crissum was good without skin inflammation and with normal function of defecation. The appearance of donor site was acceptable to patients or their parents. Conclusions Ilioinguinal flap is a good choice for reconstruction of perineal obliteration deformity after burn.

Effects of Huanglian ointment on wound healing of mice with full-thickness skin defect and the related mechanism

Zhang Xiaofen, Sun Guifang, Chen Yafeng, Ma Jiaoyang, Gao Chunfang, Sheng Xia, Feng Dianxu

2016, 32(12): 714-720. doi: 10.3760/cma.j.issn.1009-2587.2016.12.003

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Objective To observe the effects of Huanglian ointment on wound healing of mice with full-thickness skin defect, and to explore the related mechanism. Methods Thirty male C57BL/6J mice were divided into Huanglian ointment group and vehicle group according to the random number table after round wounds of full-thickness skin defect with diameter of 7.5 mm were inflicted on the back of each mouse, with 15 mice in each group. Wounds of mice in Huanglian ointment group and vehicle group were treated with Huanglian ointment and vehicle respectively from post injury day (PID) 1 on, 2 times each day. Five mice from each group were selected to observe wound changes on PID 0, 3, 7, 10, and 14, and wound healing rates were calculated. Five mice out of the 10 mice that hadn′t been used for general observation in each group were sacrificed on PID 3 and 7 respectively, and 5 mice after being used for general observation in each group were sacrificed on PID 14. Wound and skin tissue within 2 mm from the edge of wound was collected. Histologic scoring was conducted based on the histomorphological observation with HE staining. The expression of double positive cells of alpha smooth muscle actin (α-SMA) and Ki-67 (myofibroblast) in tissue of wounds of mice was observed by immunofluorescence staining. Protein expressions of transforming growth factor beta (TGF-β) and collagen in tissue of wounds of mice were determined by enzyme-linked immunosorbent assay. Data were processed with analysis of variance for repeated measurement, analysis of variance of factorial design, t test of two independent samples, one-way analysis of variance, and Bonferronni test or correction. Results (1) Wounds of mice in two groups were red and swollen on PID 0, while they were neither red nor swollen with scabs on PID 3 and 7. On PID 10, woundsof mice in Huanglian ointment group contracted obviously, while the contracted wounds of mice in vehicle group were smaller than those in Huanglian ointment group. On PID 14, wounds of most mice in Huanglian ointment group were healed, while wounds of some mice in vehicle group failed to heal. Wound healing rates of mice in two groups were close on PID 3 and 7 (with t values respectively 0.64 and 1.90, P values above 0.05). Wound healing rates of mice in Huanglian ointment group on PID 10 and 14 were (76±7)% and (93±5)% respectively, significantly higher than those of vehicle group [(48±9)% and (68±11)%, with t values respectively 7.44 and 3.89, P values below 0.01]. Wound healing rates of mice in two groups on PID 7, 10, and 14 were significantly higher than those on the previous time points of the same group (with P values below 0.01). (2) Histologic scores of wounds of mice in two groups were close on PID 3 (t=-0.76, P>0.05). Histologic scores of wounds of mice in Huanglian ointment group on PID 7 and 14 were (7.0±1.6) and (11.6±2.1) points respectively, significantly higher than those of vehicle group [(4.2±1.3) and (7.2±1.3) points, with t values respectively 1.96 and 2.50, P<0.05 or P<0.01]. Histologic scores of wounds of mice in two groups on PID 7 and 14 were significantly higher than those on the previous time points of the same group (with P values below 0.01). (3) Percentages of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice in Huanglian ointment group on PID 3 and 7 were (35±12)% and (62±10)% respectively, significantly higher than those of vehicle group [(17±12)% and (34±6)%, with t values respectively -2.48 and -5.25, P<0.05 or P<0.01]. The percentage of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice in Huanglian ointment group on PID 14 was (25±5)%, significantly lower than that of vehicle group [(44±17)%, t=2.50, P<0.05]. The percentage of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice on PID 7 was significantly higher than that on PID 3 or 14 in Huanglian ointment group (with P values below 0.01). Percentages of double positive cells of α-SMA and Ki-67 in tissue of wounds of mice on PID 7 and 14 were significantly higher than those on the previous time points in vehicle group (with P values below 0.05). (4) Protein expressions of TGF-β in tissue of wounds of mice in Huanglian ointment group on PID 3 and 7 were (396±45) and (722±96) pg/mL respectively, significantly higher than those of vehicle group [(290±42) and (382±62) pg/mL, with t values respectively -8.17 and -6.65, P values below 0.01]. Protein expressions of TGF-β in tissue of wounds of mice in two groups were close on PID 14 (t=1.60, P>0.05). The protein expression of TGF-β in tissue of wounds of mice in Huanglian ointment group on PID 7 was significantly higher than that on PID 3 or 14 (with P values below 0.01). Protein expressions of TGF-β in tissue of wounds of mice in vehicle group on PID 7 and 14 were significantly higher than those on the previous time points (with P values below 0.05). Protein expressions of collagen in tissue of wounds of mice in two groups were close on PID 3 (t=1.99, P>0.05). Protein expressions of collagen in tissue of wounds of mice in Huanglian ointment on PID 7 and 14 were (47±10) and (70±14) ng/mL respectively, significantly higher than those of vehicle group [(34±10) and (42±12) ng/mL, with t values respectively 3.15 and 3.52, P<0.05 or P<0.01]. Protein expressions of collagen in tissue of wounds of mice in two groups on PID 7 and 14 were significantly higher than those on the previous time points of the same group (P<0.05 or P<0.01). Conclusions Huanglian ointment can promote wound healing of full-thickness skin defect of mice through increasing production of myofibroblasts and protein expressions of TGF-β and collagen.

Application of laser speckle perfusion imaging in predicting wound healing time of burn patients

Jiang Meijun, Chu Zhigang, Xie Qionghui, Huang Wenwei, Ruan Jingjing, Xie Weiguo

2016, 32(12): 721-724. doi: 10.3760/cma.j.issn.1009-2587.2016.12.004

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Objective To explore the application effect of laser speckle perfusion imaging (LSPI) in predicting wound healing time of burn patients. Methods LSPI was performed in 84 adult burn patients hospitalized in department of burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital within post injury hour (PIH) 24 to 72 to detect the blood perfusion values of the wounds. The wound healing time was recorded. The 128 wounds were divided into superficial group (wound healing time shorter than or equal to 14 d, n=57) and deep group (wound healing time longer than 14 d and shorter than or equal to 28 d, n=71) according to the healing time. The blood perfusion values of the two groups were compared. Data were processed with t test or chi-square test. The receiver operating characteristic (ROC) curve was drawn and Youden index was calculated to determine the optimal critical blood perfusion value of wound healing time of the two groups, and the validity of the critical value was assessed by Kappa consistency test. Results (1) The blood perfusion value of woundsin superficial group was (6.8±1.8) perfusion unit (PU), which was significantly higher than (3.5±1.3) PU in deep group (t=11.404, P<0.01). (2) The total area under ROC curve of blood perfusion value to predict wound healing time was 0.931 (with 95% confidence interval 0.887-0.975, P<0.01). Combined with Youden index, 5.52 PU was chosen as the optimal critical value of wound healing time of the two groups, with sensitivity of 76.9% and specificity of 94.7%. (3) The healing time of 44 wounds predicted was shorter than or equal to 14 d, and the healing time of 84 wounds predicted was longer than 14 d and shorter than or equal to 28 d, while the actual number of wounds was 57 and 71, respectively. The Kappa coefficient of consistency test was 0.754 (P<0.01). Conclusion LSPI is a useful method to predict the healing time of burn wounds.

Meta-analysis on the clinical effects of allogenic acellular dermal matrix treatment for diabetic foot ulcer

Xue Chunli, Hu Zhicheng, Yang Zuxian, Li Xiaojian

2016, 32(12): 725-729. doi: 10.3760/cma.j.issn.1009-2587.2016.12.005

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Objective To analyze the clinical effects of allogenic acellular dermal matrix (ADM) treatment for diabetic foot ulcer (DFU) with meta-analysis. Methods Databases including PubMed, Cochrance Library, Embase, and OVID EBM Reviews were searched using key words " diabetic foot, diabetic ulcer, diabetic wound, acellular dermal matrix, acellular dermal regenerative tissue matrix, acellular regenerative tissue matrix, AlloDerm, SureDerm, KaroDerm, Graftjacket, Hyalomatrix PA, and Hyalograft 3D" , and Chinese Biological Abstracts, Chinese Journals Full-text Database, VIP Database, and Wanfang Database were searched using key words in Chinese version "糖尿病足,糖尿病足溃疡,异体脱细胞真皮基质,真皮基质" to obtain the published trials of allogenic ADM treatment for DFU from January 1990 to July 2015, and then meta-analysis was used to analyze the trials. The measurement indexes were wound contraction rate, wound healing rate, complete epithelization time of wound, and complication rate. Meta-analysis was conducted by RevMan 5.2 statistical software. Results A total of 5 trials involving 426 DFU patients were included, with 224 patients in group ADM who received allogenic ADM treatment and 202 patients in conventional treatment group (CT) who received conventional moist treatment. There was no statistically significant difference between group ADM and group CT in wound contraction rate, with mean difference 20.34 (with 95% confidence interval -25.27-65.94, P=0.38). The wound healing rate of patients in group ADM was higher than that in group CT, with relative risk (RR) 1.90 (with 95% confidence interval 1.29-2.80, P<0.01). There was no statistically significant difference between group ADM and group CT in complete epithelization time of wound, with mean difference 1.20 (with 95% confidence interval -2.93-0.52, P=0.17). The complication rate of patients in group ADM was lower than that in group CT, RR=0.54 (with 95% confidence interval 0.38-0.76, P<0.001). Publication bias might exist in wound contraction rate, wound healing rate, complete epithelization time of wound, and complication rate. Conclusions Compared with conventional moist treatment, allogenic ADM treatment can accelerate wound healing and reduce complication rate in patients with DFU.

Long non-coding RNA and wound healing

Liu Yang, Liu Dewu

2016, 32(12): 735-739. doi: 10.3760/cma.j.issn.1009-2587.2016.12.008

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Long non-coding RNA (lncRNA) is a class of RNA molecules longer than 200 nucleotides which does not encode proteins or only encode a few proteins, and it plays important regulatory roles in the expression of genes at the epigenetic, transcriptional, and posttranscriptional levels. The recent reports suggest that lncRNA plays a significant role in growth and development of body, cellular biological processes including in cell proliferation, differentiation, migration, and apoptosis, and regulation of wound healing processes such as re-epithelialization, angiogenesis, and scar formation. The lncRNA has become a new research hotspot in wound healing. This article reviews the role of lncRNA in different stages of wound repair to get a further understanding of molecular mechanisms of wound healing and provide a new target spot for prevention and treatment of pathological scars and wound healing.

2016, 32(12): 730-732. doi: 10.3760/cma.j.issn.1009-2587.2016.12.006

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2016, 32(12): 732-734. doi: 10.3760/cma.j.issn.1009-2587.2016.12.007

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2016, 32(12): 759-761. doi: 10.3760/cma.j.issn.1009-2587.2016.12.012

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Investigation on events of bus on fire in 6 years in the mainland of China

Wang Xingang, Liu Yong, Cen Ying, Wu Pan, Zhou Hanlei, Han Chunmao

2016, 32(12): 740-743. doi: 10.3760/cma.j.issn.1009-2587.2016.12.009

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Objective To retrospectively analyze the characteristics of events of bus on fire in 6 years in the mainland of China. Methods Events of bus on fire happened between January 2009 and December 2014 were retrieved through Baidu search engine, Chinese Journals Full-text Database, and PubMed database in the search strategy with " bus" and " fire" or " arson" as keywords combined with the name of provinces, autonomous regions, and municipalities of the mainland of China. The occurrence time, region, cause of fire, casualties of each event were recorded, and the correlative analysis was conducted. Data were processed with Microsoft Excel software. Results Totally 287 events of bus on fire were retrieved, among which 49 events happened in 2009, 36 events happened in 2010, 35 events happened in 2011, 37 events happened in 2012, and respectively 65 events happened in 2013 and 2014. The events of bus on fire most frequently happened in June and July, respectively 49 and 39 events. Among the distribution of occurrence regions of events of bus on fire, there were 78 events (27.18%) in east China, 52 events (18.12%) in northeast China, 41 events (14.29%) both in north China and south China. Among the causes of events of bus on fire, spontaneous combustion of bus ranked in the first (267 events, accounting for 93.03%), followed by arson (13 events, accounting for 4.53%). Among the 13 events of bus on fire caused by arson, 7 events happened between 16: 00 and 20: 00, and 3 events happened between 8: 00 and 10: 00. Totally 27 events of bus on fire (9.41%) were with casualties, among which 13 events (48.15%) were caused by spontaneous combustion of bus, 10 events (37.04%) were caused by arson, and 4 events (14.81%) were caused by traffic accidents. Arson caused the most severe casualties (at least 88 deaths and 287 injuries), followed by spontaneous combustion of bus (at least 35 deaths and 140 injuries) and traffic accidents (at least 9 deaths and 20 injuries). Conclusions Events of bus on fire happened more frequently in recent years in the mainland of China, and the frequencies were much higher especially in June and July. Most events were caused by spontaneous combustion of bus, followed by arson. Most of the events of bus on fire caused by arson happened in the morning and evening rush hours of urban traffic, and althouth the occurrence rate was not high, the casualties were most severe.

Mechanism of protective effects of tumor necrosis factor receptor associated protein 1 on hypoxic cardiomyocytes of rats

Xiang Fei, Zhang Dongxia, Ma Siyuan, Huang Yuesheng

2016, 32(12): 744-751. doi: 10.3760/cma.j.issn.1009-2587.2016.12.010

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Objective To investigate the mechanism of protective effects of tumor necrosis factor receptor associated protein 1 (TRAP1) on hypoxic cardiomyocytes of rats. Methods Primary cultured cardiomyocytes were obtained from neonatal Sprague-Dawley rats (aged 1 to 3 days) and then used in the following experiments. (1) Cells were divided into group TRAP1 and control group according to the random number table (the same grouping method below), and then the total protein of cells was extracted. Total protein of cells in group TRAP1 was added with mouse anti-rat TRAP1 monoclonal antibody, while that in control group was added with the same type of IgG from mouse. Co-immunoprecipitation and protein mass spectrography analysis were used to determine the possible proteins interacted with TRAP1. (2) Cells were divided into normoxia blank control group (NBC), normoxia+ TRAP1 interference control group (NTIC), normoxia+ TRAP1 interference group (NTI), normoxia+ TRAP1 over-expression control group (NTOC), and normoxia+ TRAP1 over-expression group (NTO), with 1 well in each group. Cells in group NBC were routinely cultured, while cells in the latter four groups were respectively added with TRAP1 RNA interference empty virus vector, TRAP1 RNA interference adenovirus vector, TRAP1 over-expression empty virus vector, and TRAP1 over-expression adenovirus vector. Another batch of cells were divided into group NBC, hypoxic blank control group (HBC), hypoxic+ TRAP1 interference control group (HTIC), hypoxic+ TRAP1 interference group (HTI), hypoxic+ TRAP1 over-expression control group (HTOC), and hypoxic+ TRAP1 over-expression group (HTO), with 1 well in each group. Cells in hypoxic groups were under hypoxic condition for 6 hours after being treated as those in the corresponding normoxia groups, respectively. The mRNA expression of cytochrome c oxidase subunit Ⅱ (COXⅡ) of cells in each group was detected by real time fluorescent quantitive reverse transcription polymerase chain reaction. Experiments were repeated for three times. (3) Cells were divided into group NBC, group HBC, group HTOC, group HTO, hypoxic+ TRAP1 over-expression+ COXⅡinterference control group (HTOCIC), and hypoxic+ TRAP1 over-expression+ COXⅡinterference group (HTOCI), with 3 wells in each group. Cells in the previous 4 groups were treated as those in experiment (2). Cells in group HTOCIC and HTOCI were respectively transfected with COXⅡ RNA interference empty virus vector and COXⅡ RNA interference adenovirus vector, and then both added with TRAP1 over-expression adenovirus vector. The proliferation activity of cells was determined by cell counting kit 8 and microplate reader, and the ratio of death cells was measured by propidium lodide and Hoechst 33342 staining. Another batch of cells were divided into group NBC, group HBC, group HTIC, group HTI, hypoxic+ TRAP1 interference+ COXⅡover-expression control group (HTICOC), and hypoxic+ TRAP1 interference+ COXⅡ over-expression group (HTICO), with 3 wells in each group. Cells in the previous 4 groups were treated as those in experiment (2). Cells in group HTICOC and HTICO were both transfected with TRAP1 RNA interference adenovirus vector, and then respectively added with COXⅡ over-expression empty virus vector and COXⅡ over-expression adenovirus vector. The proliferation activity of cells and the ratio of death cells were detected as before. Experiments were repeated for three times. Data were processed with one-way analysis of variance and LSD test. Results (1) The expression of TRAP1 was found in cells of group TRAP1, while that was not found in cells of control group. The possible proteins interacted with TRAP1 were keratin, COXⅡ, and an unknown protein with predicted molecular weight 13×10³. (2) Compared with that in group NBC, the mRNA expression of COXⅡof cells had no significant change in group NTIC and group NTOC (with P values above 0.05), but significantly decreased in group NTI (P<0.01), and significantly increased in group NTO (P<0.01). Compared with that in group NBC, the mRNA expression of COXⅡof cells in group HBC was significantly decreased (P<0.01). Compared with that in group HBC, the mRNA expression of COXⅡof cells had no significant change in group HTIC and group HTOC (with P values above 0.05), but significantly decreased in group HTI (P<0.01), and significantly increased in group HTO (P<0.01). (3) The proliferation activity of cells in group NBC, group HBC, group HTOC, group HTO, group HTOCIC, and group HTOCI was respectively 0.498±0.022, 0.303±0.018, 0.313±0.032, 0.456±0.031, 0.448±0.034, and 0.335±0.026, and the ratios of death cells in above groups were respectively (4.7±1.5)%, (24.7±3.1)%, (26.0±2.7)%, (13.3±2.5)%, (12.7±2.1)%, and (21.0±1.7)%. Compared with those in group NBC, the proliferation activity of cells in HBC was decreased, while the ratio of death cells was increased (with P values below 0.01). Compared with those in group HBC, the proliferation activity of cells and the ratio of death cells in group HTOC had no significant change (with P values above 0.05), while the proliferation activity of cells was increased and the ratio of death cells was decreased in group HTO (with P values below 0.01). Compared with those in group HTO, the proliferation activity of cells and the ratio of death cells in group HTOCIC had no significant change (with P values above 0.05), while the proliferation activity of cells was decreased and the ratio of death cells was increased in group HTOCI (with P values below 0.01). (4) The proliferation activity of cells in group NBC, group HBC, group HTIC, group HTI, group HTICOC, and group HTICO was respectively 0.444±0.025, 0.275±0.016, 0.283±0.021, 0.150±0.009, 0.135±0.011, and 0.237±0.017, and the ratios of death cells in above groups were respectively (3.7±0.6)%, (21.0±2.7)%, (20.3±3.1)%, (31.7±2.5)%, (33.3±3.2)%, and (19.3±1.5)%. Compared with those in group HBC, the proliferation activity of cells and the ratio of death cells in group HTIC had no significant change (with P values above 0.05). Compared with those in group HBC and group HTIC, the proliferation activity of cells was decreased and the ratio of death cells was significantly increased in group HTI (with P values below 0.01). Compared with those in group HTI, the proliferation activity of cells and the ratio of death cells in group HTICOC had no significant change (with P values above 0.05), while the proliferation activity of cells was increased and the ratio of death cells was significantly decreased in group HTICO (with P values below 0.01). Conclusions TRAP1 can up-regulate the expression of COXⅡ mRNA, and COXⅡ is one of the downstream effector molecules that TRAP1 mediates its protective effects on hypoxic cardiomyocytes.

Influences of exendin-4 on the secretion function of islet beta cells from rats in the early stage of severe scald

Zhao Dongxu, Ma Li, Shen Chuan′an, Li Dawei, Shang Yuru, Yin Kai, Cheng Wenfeng, Wang Xin, Liu Zhaoxing

2016, 32(12): 752-758. doi: 10.3760/cma.j.issn.1009-2587.2016.12.011

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Objective To observe the secretion function changes of islet beta cells isolated from rats in the early stage of severe scald, and to explore the influence of them. Methods Thirty-six Wistar rats were divided into sham injury (SI) group, sham injury+ exendin-4 (SIE) group, scald (S) group, and scald+ exendin-4 (SE) group according to the random number table, with 9 rats in each group. Rats in groups S and SE were inflicted with 50% total body surface area full-thickness scald by a 12-s immersion of back and a 6-s immersion of abdomen in 94 ℃ hot water. Rats in groups SI and SIE were sham injured through immersion of back and abdomen in 37 ℃ warm water. Rats in groups S and SE were subcutaneously injected with exendin-4 (4 μg/kg) twice a day post injury, while rats in groups SI and SIE were subcutaneously injected with sterile water in the same volume. At post injury hour (PIH) 72, the following detections were performed. Eight rats of each group were respectively selected to measure level of fasting blood glucose with cutting-tail method, and to detect plasma level of glucagon-like peptide 1 (GLP-1) and serum level of insulin by enzyme-linked immunosorbent assay (ELISA). The insulin resistant index (HOMA-IR) was calculated. Six rats of each group were respectively selected for islet isolation. The isolated rat islets were stimulated with RPMI 1640 medium containing 2.8 or 16.7 mmol/L glucose, respectively. Insulin content in supernatant was detected by ELISA, and insulin secretion index was calculated with 6 samples in each group. The isolated islets from 3 rats of each group were selected for the observation of the super-structure of islet beta cells under transmission electron microscope. The number of docked granules in per 10 μm membrane of islet beta cells and the ratio of insulin vesicles to the total insulin granules were calculated with 3 samples in each group. Data were processed with one-way analysis of variance and LSD test. Results (1) Compared with that in group S, levels of fasting blood glucose of rats in group SI, SIE, and SE were significantly decreased (P<0.05 or P<0.01). (2) Compared with those in group SI, plasma level of GLP-1 of rats in group SIE was significantly increased (P<0.05), while serum level of insulin and HOMA-IR of rats did not change obviously (with P values above 0.05). Plasma levels of GLP-1 of rats in groups S and SE were significantly decreased (with P values below 0.01), while serum levels of insulin and HOMA-IR were obviously increased (with P values below 0.01). Compared with those in group SIE, plasma levels of GLP-1 of rats in groups S and SE were significantly decreased (with P values below 0.01), while serum levels of insulin and HOMA-IR were significantly increased (with P values below 0.01). Compared with those in group S, plasma level of GLP-1 and serum level of insulin of rats in group SE were significantly increased (with P values below 0.01), while HOMA-IR was significantly decreased (P<0.05). (3) There was no statistically significant difference in the insulin secretion content of rats in the 4 groups when stimulated with 2.8 mmol/L glucose (P>0.05). Under stimulation of 16.7 mmol/L glucose, compared with that in group SI, the insulin secretion content of rats in groups SIE and SE were significantly increased (P<0.05 or P<0.01), while in group S it was significantly decreased (P<0.05). Compared with that in group SE, the insulin secretion content of rats in group S was significantly decreased (P<0.01) . Compared with that in group S, the insulin secretion content of rats in group SE was significantly increased (P<0.01). Compared with that in group SI (2.25±0.20), the insulin secretion index of rats in group SE (2.68±0.24) was significantly increased (P<0.05). Compared with that in group SIE (2.47±0.18), the insulin secretion index of rats in group S (2.11±0.28) was significantly decreased (P<0.05). Compared with that in group S, the insulin secretion index of rats in group SE was significantly increased (P<0.01). (4) Compared with those in group SI, the number of docked granules per 10 μm membrane of islet beta cells in group SE was significantly increased (P<0.05), while the ratio of insulin vesicles of rat islet beta cells in group S was significantly increased (P<0.01). Compared with those in group SE, the number of docked granules per 10 μm membrane of islet beta cells in group S was significantly decreased (P<0.01), while the ratio of insulin vesicles of rat islet beta cells was significantly increased (P<0.05). Compared with those in group S, the number of docked granules per 10 μm membrane of islet beta cells in group SE was significantly increased (P<0.01), while the ratio of insulin vesicles of rat islet beta cells was significantly decreased (P<0.05). Conclusions In the early stage of severe scald in rats, level of GLP-1 is decreased and the insulin secretion function of islet beta cells is injured. Long-lasting GLP-1 analogous exendin-4 can improve the secretion function of isolated islet beta cells from severely scalded rats.

Advances in the research of peripheral blood mononuclear cell-derived multipotential cell

Xie Ying, Chen Bin, Wang Hong, Wang Kuan, Li Ran

2016, 32(12): 762-764. doi: 10.3760/cma.j.issn.1009-2587.2016.12.013

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Mononuclear cell -derived multipotential cell (MOMC)is a unique cell population that derived from circulating CD14 ⁺ mononuclear cell, with phenotypic characteristics of CD14⁺ , CD45⁺ , CD34⁺ , as well as type Ⅰ collagen. It can be induced to differentiate into a wide range of mesenchymal lineages, including endothelium-like cells, myocardium-like cells, neuron-like cells, osteoid cells, chondroid cells, lipoid cells, myoid cells, epidermoid cells, and hepatoid cells. More strikingly, MOMC is easy to be obtained, and it can expand easily in vitro, which can be transplantated autologously without ethical limitations. MOMC is an ideal source of cell therapy for tissue regeneration and wound repair.

Advances in the research of sepsis-related stress response

Qiu Minshan, Yin Haiyan

2016, 32(12): 765-768. doi: 10.3760/cma.j.issn.1009-2587.2016.12.014

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In recent years, the levels of anti-infection and organ function support of sepsis have been improved, but the mortality rate remains high, which brings about challenges for critical care clinicians. Sources of sepsis-related stress response include severe infection, frequent therapeutic procedures, routine nursing measures, and physical constraints, etc. Although sepsis-related stress response has obtained a lot of concern, its understanding is still in the stage of research and the treatment method is nonspecific. This article summarizes the pathogenesis, evaluation methods, and treatment of sepsis-related stress response, with a hope to provide reference for its clinical treatment.

2016 Vol. 32, No. 12

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