中华烧伤与创面修复杂志

Wound repair and functional reconstruction of high-voltage electrical burns

Shen Yuming

2018, 34(5): 257-262. doi: 10.3760/cma.j.issn.1009-2587.2018.05.001

PDF

Abstract:
In the repair of burn wound, high-voltage electrical burn wound is still the most complicated and the most difficult one to deal with. According to the clinical experience of author and the literature at home and abroad, this article systematically discusses the early treatment of high-voltage electrical burn wounds, including limbs escharotomy, fasciotomy, and early debridement, and the repair of high-voltage electrical burn wounds in various parts, especially in some special parts, focusing on the repair of the life-threatening parts and site of large vascular injury. At the same time, this article discusses the feasibility and necessity of functional reconstruction. We should make full use of modern repair technology and innovation, interdisciplinary cooperation, so as to reduce disability rate, amputation rate, and mortality of patients with high-voltage electrical burns as far as possible.

New exploration on clinical treatment of injuries caused by uncommon agents or in extraordinary regions

Liu Yi

2018, 34(5): 263-265. doi: 10.3760/cma.j.issn.1009-2587.2018.05.002

Abstract

PDF

Abstract:
Burns caused by uncommon agents means those caused by other agents except heating power, with special characteristics existing in traumatogenesis, pathophysiology, and clinical manifestation. With the development of social economy, various new techniques and new equipments are springing up. In the practical use, improper operations would become traumatogenic agents and cause various special types of trauma. In addition, some special injuries emerged with the changes in people′s lifestyle. For battle injury, some new war wounds, which are different from fire-arm injuries in the past, appeared with the emergence of acoustic wave, light wave, electrical and magnetic weapons. Extraordinary regions are those located on body surface with anatomic and physiological particularity. Injuries caused by uncommon traumatogenic agent or in extraordinary region are different from those ordinary burns and trauma, and their clinical treatments have special characteristics. Clinical treatments were studied aiming at these special characteristics, and some achievements in treatment of high-voltage electrical burn, hydrofluoric acid burn, wounds on special regions, and new types of burns and trauma have been made. However, a doctor′s duty is not only to cure the diseases and save the patients′ lives, but also to prevent the diseases. The suitable treatment and precautionary measures for the new types of burns and trauma that differ from ordinary burns and trauma in the past remain to be explored.

Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees

Liu Mengdong, Yang Xuekang, Han Fu, Fang Zhuoqun, Zhang Yue, Hu Dahai, Tao Ke

2018, 34(5): 266-270. doi: 10.3760/cma.j.issn.1009-2587.2018.05.003

Abstract

PDF

Abstract:
Objective Strategy for wound repair of skin and soft tissue defect and systematic rehabilitation treatment for functional reconstruction of patients with severe burn or trauma on knees. Methods From January 2015 to October 2016, 26 patients with skin and soft tissue defect on knees after severe burn or trauma were hospitalized in our unit. Among these patients, 14 patients had patellar ligament defect, and 16 patients had knee joint capsule defect. Wound debridement was operated on 1 to 3 days after admission. After debridement, the area of skin and soft tissue defect ranged from 10 cm×7 cm to 42 cm×18 cm. Vacuum sealing drainage (VSD) treatment was performed after debridement, and flap transplantation operation was performed after VSD treatment for 5 to 7 days. Defects of nine patients were treated with local rotation flaps. Seven patients with skin and soft tissue defects on knees and knee joint capsule defects of 5 cm×3 cm to 9 cm×7 cm were treated with free anterolateral femoral flaps combined with fascia lata. Ten patients with skin and soft tissue defects on knees and patellar ligament defects of 6 cm×3 cm to 12 cm×4 cm were treated with free anterolateral femoral flaps combined with iliotibial tract. The area of flaps ranged from 11 cm×9 cm to 22 cm×15 cm. After flap transplantation operation, functional reconstruction of knee joint was carried out according to early, continuous, and sequential systematic rehabilitation treatment strategy. The pain degree and function of knee joint of patients were scored by the International Knee Documentation Committee (IKDC) Knee Evaluation Form before operation and 12 months after operation. The knee joint flexion and extension degrees of patients were measured by joint protractor in 2 weeks and 12 months after operation. The color Doppler ultrasound was used to evaluate integrity of knee joint capsule and continuity of patellar ligament of patients in 6 and 12 months after operation. Results All flaps of 26 patients survived well, and wounds healed completely after the operation. Distal parts of flaps of 2 patients treated with free anterolateral femoral flaps had local necrosis after the operation, and their wounds healed after debridement and transplantation of autologous intermediate split-thickness skin graft of thigh. The IKDC Knee Evaluation Form score of patients was (79±8) points in 12 months after operation, which was significantly higher than (64±7) points before operation (t=7.20, P<0.05). The flexion degree of knee joint of patients was (117±10)° in 12 months after operation, which was significantly larger than (35±8)° in 2 weeks after operation (t=32.65, P<0.05). The extension degree of knee joint of patients was (12±9)° in 12 months after operation, which was significantly smaller than (61±9)° in 2 weeks after operation (t=19.63, P<0.05). In 6 and 12 months after operation, 9 patients treated with local rotation flaps had good integrity of knee joint capsule and continuity of patellar ligament; 7 patients treated with free anterolateral femoral flaps and fascia lata had good integrity of knee joint capsule; 10 patients treated with free anterolateral femoral flaps and iliotibial tract had good continuity of patellar ligament. During follow-up of 12 months, all flaps survived well; knees of all patients had good appearance; knee joints functioned normally. Conclusions Good appearance and function of knees can be achieved by repairing wound of skin and soft tissue defect on knees after severe burn or trauma with local rotation flaps or free anterolateral femoral flaps with fascia lata or iliotibial tract plus systematic rehabilitation treatment of knee joint in early stage after flap transplantation operation.

Analysis on clinical characteristics of 316 patients with hydrofluoric acid burns

Tian Pengfei, Wang Xin′gang, Zhang Yuanhai, Zhang Jianfen, Xu Bin, Hu Zuliang, Ye Chunjiang, Han Chunmao

2018, 34(5): 271-276. doi: 10.3760/cma.j.issn.1009-2587.2018.05.004

Abstract

PDF

Abstract:
Objective To investigate the clinical characteristics of patients with hydrofluoric acid (HF) burns. Methods Clinical data of 316 patients with HF burns admitted to Zhejiang Quhua Hospital from January 2004 to December 2016 were retrospectively analyzed. Patients were divided into non and mild poisoning group (NMP, n=157), moderate poisoning group (MP, n=120), and severe and fatal poisoning group (SFP, n=39) based on the severity of poisoning. Occurrences of hypocalcemia, hypomagnesemia, hypokalemia, and hyperkalemia of patients within 24 hours after admission were recorded. Values of emergency urinary fluoride of patients on admission were recorded. Values of urinary fluoride of patients admitted to hospital in 4 hours post injury in groups MP and SFP at post injury hour 4, 12, and 24 and on post injury day 2, 3, 4, 5, 6, and 7 were also recorded. Electrocardiographic abnormalities of patients within 24 hours after admission were recorded. Data were processed with chi-square test, Kruskal-Wallis H test, and Mann-Whitney U test. Results (1) Hypocalcemia, hypomagnesemia, and hypokalemia occurred in some patients in each of the three groups, but no patient had hyperkalemia. Taking serum calcium namely total serum calcium as reference, the incidence rate of hypocalcemia of patients in group NMP was close to that in group MP (χ²=0.05, P>0.05). The incidence rate of hypocalcemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ²=10.53, 7.92, P<0.01). The incidence rates of hypokalemia in the three groups were close (χ²=0.63, P>0.05). Taking serum ionized calcium as reference, the incidence ratio of hypocalcemia of patients in group NMP was close to that in group MP (χ²=0.01, P>0.05), while there were statistically significant differences in incidence ratio of hypocalcemia of patients between group SFP and each of group NMP and group MP (χ²=4.66, 4.47, P<0.05). Taking serum calcium as reference, the incidence rate of hypocalcemia of patients was 7.3% (23/316). Taking serum ionized calcium as reference, the incidence rate of hypocalcemia of patients was 60.0% (42/70), which was significantly higher than that of taking serum calcium as reference (χ²=113.74, P<0.01). The incidence rates of hypomagnesemia of patients in groups MP and NMP were close (χ²=0.02, P>0.05). The incidence rate of hypomagnesemia of patients in group SFP was significantly higher than that in group NMP or group MP (χ²=14.69, 9.94, P<0.01). (2) The urinary fluoride levels were tested in 288 patients, with the value of emergency urinary fluoride of patients on admission 0.2-590.0 mg/L. The values of urinary fluoride of 202 patients were above the normal value. The values of emergency urinary fluoride of patients in groups NMP, MP, and SFP were 2.15 (1.11, 4.30), 5.89 (1.72, 14.25), and 36.0 (13.2, 103.2) mg/L, respectively. The values of emergency urinary fluoride of patients in groups MP and SFP were significantly higher than the value in group NMP (χ²=23.28, 66.03, P<0.01). The value of emergency urinary fluoride of patients in group SFP was significantly higher than that in group MP (χ²=39.23, P<0.01). The value of urinary fluoride of 33 patients admitted to hospital within 4 hours post injury in groups MP and SFP reached the top at 4 hours post injury and then gradually declined, which returned to normal on about 5 days post injury. The values of urinary fluoride of patients in group SFP at 4, 12, and 24 hours post injury and on 2, 3, 4, 5, 6, and 7 days post injury were significantly higher than those in group MP (Z=-4.28, -4.15, -3.81, -4.21, -2.48, -2.06, -2.31, -2.68, -3.03, P<0.05 or P<0.01). (3) Twenty-seven patients had electrocardiographic abnormality. There were 12 patients with T wave changes (the most common), 8 patients with ST-T changes, 6 patients with ventricular arrhythmias, 6 patients with conduction block, and 1 patient with broadened QRS waveform. There was no patient with prolonged Q-T interval. The ratios of patients with the above electrocardiographic abnormalities in group SFP were higher than those in group NMP and group MP. Conclusions Clinical manifestations of patients with HF burn are hypocalcemia, hypomagnesemia, hypokalemia, and electrocardiographic abnormality. In addition to routine serum electrolyte and electrocardiogram monitoring, the levels of serum ionized calcium and urinary fluoride can be helpful to evaluate the severity of illness of the patients.

Analysis on effects of modified dosage of calcium gluconate on patients with hydrofluoric acid burns not in hands or feet

Zhang Yuanhai, Wang Xin′gang, Tian Pengfei, Zhang Jianfen, Hu Zuliang, Xu Bin, Ye Chunjiang, Ni Liangfang, Han Chunmao

2018, 34(5): 277-282. doi: 10.3760/cma.j.issn.1009-2587.2018.05.005

Abstract

PDF

Abstract:
Objective To retrospectively explore the effects of modified dosage of calcium gluconate (CG) on the patients with hydrofluoric acid burns not in hands or feet. Methods One hundred and sixty patients with hydrofluoric acid burns not in hands or feet were hospitalized in our burn ward from January 2004 to December 2017. Based on the dosage of CG at different admission time, 76 patients hospitalized from January 2004 to December 2012 were included in traditional group, and 84 patients hospitalized from January 2013 to December 2017 were included in modified group. For patients in the two groups, subcutaneous injection of CG solution at one time was immediately conducted on admission in topical treatment. In traditional group, the injection was CG solution with mass concentration of 100 g/L. For wounds of superficial partial-thickness and above degree, CG solution was prescribed at the dosage of 50 mg/cm². Wounds of superficial-thickness or mass fraction of hydrofluoric acid less than 20.0% did not receive injection. In modified group, the mass concentration of CG solution for injection was diluted with normal saline to 25 g/L. For wounds of deep partial-thickness and above degree, CG solution was prescribed at the dosage of (50×mass fraction of hydrofluoric acid) mg/cm². For wounds of superficial partial-thickness, CG solution was prescribed at the dosage of (25×mass fraction of hydrofluoric acid) mg/cm². For wounds of superficial-thickness, CG solution was prescribed at the dosage of 2.5 mg/cm². For systemic treatment, the injection velocity of CG solution via venous access was adjusted according to the level of serum calcium namely total serum calcium of patients in traditional group. In modified group, serum ionized calcium was additionally detected through automatic blood gas analyzer by the bed to regulate the injection velocity of CG via venous access. The incidence rate of hypercalcemia and mortality of patients after treatment in the two groups, and the situation about treatment of survivors in the two groups were analyzed. Data were processed with chi-square test, Fisher′s exact probability test, t test, and Mann-Whitney U test. Results (1) After treatment, 9 patients (11.8%) had hypercalcemia, while the other 67 patients (88.2%) did not have hypercalcemia in traditional group. Two patients (2.4%) had hypercalcemia, while the other 82 patients (97.6%) did not have hypercalcemia in modified group. The incidence rate of hypercalcemia of patients in traditional group was significantly higher than that in modified group (χ²=5.579, P=0.02). (2) There were two deaths (2.6%) and 74 survivors (97.4%) in traditional group, while there were two deaths (2.4%) and 82 survivors (97.6%) in modified group. The mortalities of patients in the two groups were close (P>0.05). (3) The ratios of eschar excision and skin grafting and hyperplastic scar formation, wound healing time, and ratio of esophageal scar stenosis of survivors in the two groups were close (χ²=0.002, 0.054, Z=0.66, P>0.05). Conclusions Hydrofluoric acid is highly dangerous. The early management of patients with hydrofluoric acid burns emphasizing specialized dosage of CG for treatment can be helpful to reduce incidence of complications and improve the safety of treatment.

Effects of anteriolateral thigh perforator flap and fascia lata transplantation in combination with computed tomography angiography on repair of electrical burn wounds of head with skull exposure and necrosis

Li Xiaoqing, Wang Xin, Han Yalong, Ji Gang, Chen Zonghua, Zhang Jia, Zhu Jianping, Duan Jianxing, He Yongjing, Yang Xiaomin, Liu Wenjun

2018, 34(5): 283-287. doi: 10.3760/cma.j.issn.1009-2587.2018.05.006

Abstract

PDF

Abstract:
Objective To explore the effects of anteriolateral thigh perforator flap and fascia lata transplantation in combination with computed tomography angiography (CTA) on repair of electrical burn wounds of head with skull exposure and necrosis. Methods Seven patients with head electrical burns accompanied by skull exposure and necrosis were admitted to our burn center from March 2016 to December 2017. Head CTA was performed before the operation. The diameters of the facial artery and vein or the superficial temporal artery and vein were measured, and their locations were marked on the body surface. Preoperative CTA for flap donor sites in lower extremities were also performed to track the descending branch of the lateral circumflex femoral artery with the similar diameter as the recipient vessels on the head, and their locations were marked on the body surface. Routine wound debridement and skull drilling were performed successively. The size of the wounds after debridement ranged from 12 cm×8 cm to 20 cm×12 cm, and the areas of skull exposure ranged from 8 cm×6 cm to 15 cm×10 cm. Anteriolateral thigh perforator flaps with areas from 13 cm×9 cm to 21 cm×13 cm containing 5-10 cm long vascular pedicles were designed and dissected accordingly. The fascia lata under the flap with area from 5 cm×2 cm to 10 cm×3 cm was dissected according to the length of vascular pedicle. The fascia lata was transplanted to cover the exposed skull, and the anteriolateral thigh perforator flap was transplanted afterwards. The descending branch of the lateral circumflex femoral artery and its accompanying vein of the flap were anastomosed with superficial temporal artery and vein or facial artery and vein before the suture of flap. The flap donor sites were covered by intermediate split-thickness skin graft collected from contralateral thigh or abdomen. Results The descending branch of the lateral circumflex femoral artery and its accompanying vein were anastomosed with superficial temporal artery and vein in six patients, while those with facial artery and vein in one patient. All the flaps survived after the operation, and no vascular crisis was observed. Wound healing was satisfactory. One patient was lost to follow up. Six patients were followed up for 6 to 10 months. The patients were bald in the head operation area with acceptable appearance. No psychiatric symptom such as headache or epileptic seizure was reported. The flap donor sites were normal in appearance. The muscle strength of the lower extremities all reached grade V. The sensation and movement of the lower extremities were normal. Conclusions Anterolateral thigh perforator flap with fascia lata transplantation can effectively repair electrical burn wounds of head with skull exposure and necrosis. The fascia lata can be used to protect the vascular pedicle of flaps, which is beneficial to the survival of the flap. Preoperative head and lower extremities CTA can provide reference for intraoperative vascular exploration in donor site and recipient area, so as to shorten operation time.

2018, 34(5): 276-276. doi: 10.3760/cma.j.issn.1009-2587.2018.05.101

Abstract

Abstract:

2018, 34(5): 282-282. doi: 10.3760/cma.j.issn.1009-2587.2018.05.103

Abstract

Abstract:

2018, 34(5): 282-282. doi: 10.3760/cma.j.issn.1009-2587.2018.05.102

Abstract

Abstract:

2018, 34(5): 287-287. doi: 10.3760/cma.j.issn.1009-2587.2018.05.104

Abstract

Abstract:

2018, 34(5): 288-290. doi: 10.3760/cma.j.issn.1009-2587.2018.05.007

Abstract

PDF

Abstract:

2018, 34(5): 290-292. doi: 10.3760/cma.j.issn.1009-2587.2018.05.008

Abstract

Abstract:

2018, 34(5): 293-296. doi: 10.3760/cma.j.issn.1009-2587.2018.05.009

Abstract

PDF

Abstract:

2018, 34(5): 309-310. doi: 10.3760/cma.j.issn.1009-2587.2018.05.012

Abstract

PDF

Abstract:

2018, 34(5): 311-313. doi: 10.3760/cma.j.issn.1009-2587.2018.05.013

Abstract

PDF

Abstract:

Establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography

Yang Li, Fang Bairong, He Jiyong, Wang Xiancheng

2018, 34(5): 297-302. doi: 10.3760/cma.j.issn.1009-2587.2018.05.010

Abstract

PDF

Abstract:
Objective To explore the establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography (CTA). Methods Six patients with breast absence after modified radical mastectomy because of breast cancer, 5 patients with congenital absence of vagina, and 6 patients with Paget′s disease of penis and scrotum were hospitalized in our unit from January 2012 to April 2017. The size of wounds after excision of the lesion or that of flaps needed for reconstruction ranged from 17 cm×5 cm to 25 cm×9 cm. Abdominal CTA was performed before the surgery, and data of CTA were sent to CT workstation to make three-dimensional model of deep inferior epigastric artery perforator flap according to shape and size of wound. The number, course, and location of deep inferior epigastric artery, vein, and their perforators, and the superficial inferior epigastric vein were observed in the above-mentioned three-dimensional model. The rectangular plane coordinate system with the umbilicus as the origin was established to locate and observe course and type of the largest deep inferior epigastric artery perforator in left and right side. Deep inferior epigastric artery perforator flaps were designed and deep inferior epigastric artery perforators etc. were marked according to three-dimensional models of the flaps before the surgery. The condition observed in three-dimensional model of the flap was compared with the clinical condition in the surgery of free transverse bilateral deep inferior epigastric artery perforator flap transplantation for breast reconstruction and longitudinal pedicled thinned unilateral deep inferior epigastric artery perforator flap transplantation for vagina reconstruction and wound repair of Paget′s disease of penis or scrotum. The size of flap ranged from 17 cm×6 cm to 25 cm×10 cm. Results Seventeen three-dimensional models of deep inferior epigastric artery perforator flaps were established, including 6 bilateral models and 11 unilateral models. Seventy-two reliable deep inferior epigastric artery perforators were observed in the three-dimensional model with 3.2±0.7 in the right and 3.1±0.8 in the left. The locations of the largest deep inferior epigastric artery perforators in the right and left were [(-3.2±1.4) cm, (-1.0±0.7) cm] and [(4.0±1.2) cm, (-1.2±1.1) cm] respectively. Fourteen largest deep inferior epigastric artery perforators coursed directly and nine coursed tortuously in the rectus muscle. Twenty-three superficial inferior epigastric veins were detected in the three-dimensional models of the flaps. The number, location, and course of deep inferior epigastric artery and vein and superficial inferior epigastric vein observed in the three-dimensional model of deep inferior epigastric artery perforator flap were in accordance with the condition observed in the surgery. Seventy reliable deep inferior epigastric artery perforators were detected in the surgery, and the other 2 perforators were unclear due to bleeding. Course of these perforators were in accordance with the condition observed in the three-dimensional model. Deep inferior epigastric artery perforator flaps of all patients survived well with no complication except that 1 patient suffered from delayed healing of wound in perineum. During follow-up of 1 to 12 months, all flaps survived with good shape and texture. Conclusions The three-dimensional model of deep inferior epigastric artery perforator flap based on CTA can be established easily and can provide information of number, location, and course of deep inferior epigastric artery, vein, and their perforators, and superficial inferior epigastric vein to guide preoperative design and intraoperative dissection of the flap effectively.

Effects of decline of pH value on cardiomyocyte viability of rats and the mechanism

Yang Lei, Zhao Liping, Cui Lin, Huang Yao, Ye Jingying, Zhang Qiong, Zhang Dongxia, Huang Yuesheng

2018, 34(5): 303-308. doi: 10.3760/cma.j.issn.1009-2587.2018.05.011

Abstract

PDF

Abstract:
Objective To explore the effects of decline of pH value on cardiomyocyte viability of rats, and to analyze the possible mechanism. Methods Hearts of five newborn Sprague-Dawley rats were isolated, and then primary cardiomyocytes were cultured and used in the following experiments. (1) The primary cardiomyocytes were divided into pH 7.4+ 6 h, pH 7.0+ 6 h, pH 6.5+ 6 h, pH 6.0+ 6 h, pH 6.5+ 1 h, and pH 6.5+ 3 h groups according to the random number table, with 4 wells in each group. After being routinely cultured for 48 h (similarly hereinafter), cells in pH 7.4+ 6 h, pH 7.0+ 6 h, pH 6.5+ 6 h, and pH 6.0+ 6 h groups were cultured with pH 7.4, pH 7.0, pH 6.5, and pH 6.0 DMEM-F12 medium (similarly hereinafter), respectively, and then they were cultured for 6 h. Cells in pH 6.5+ 1 h and pH 6.5+ 3 h groups were cultured with pH 6.5 medium, and then they were cultured for 1 h and 3 h, respectively. Viability of cells was detected by methyl-thiazolyl-tetrazolium (MTT) method. (2) The primary cardiomyocytes were divided into pH 7.4, pH 6.5, and pH 6.5+ taxol groups according to the random number table, with 2 wells in each group. Cells in pH 7.4 group were cultured with pH 7.4 medium, while cells in pH 6.5 and pH 6.5+ taxol groups were cultured with pH 6.5 medium. Cells in pH 6.5+ taxol group were added with taxol of a final molarity of 0.2 μmol/L in addition, and then they were cultured for 6 h. Morphology and density of microtubule of cells was detected by immunofluorescence assay. (3) The primary cardiomyocytes were grouped and treated as in experiment (2), with 2 wells in each group. The expressions of polymerized microtubulin and free microtubulin were determined with Western blotting. (4) The primary cardiomyocytes were grouped and treated as in experiment (2), with 4 wells in each group. Viability of cells after treated with taxol was detected by MTT method. Data were processed with one-way analysis of variance and LSD-t test. Results (1) The viability of cells in pH 7.4+ 6 h, pH 7.0+ 6 h, pH 6.5+ 6 h, pH 6.0+ 6 h, pH 6.5+ 1 h, and pH 6.5+ 3 h groups were 1.00±0.08, 0.90±0.08, 0.85±0.06, 0.83±0.04, 0.91±0.10, and 0.89±0.10, respectively. Compared with that in pH 7.4+ 6 h group, viability of cells in pH 7.0+ 6 h, pH 6.5+ 6 h, pH 6.0+ 6 h, pH 6.5+ 1 h, and pH 6.5+ 3 h groups were all decreased in different degrees (t=2.476, 4.002, 4.996, 2.168, 2.400, P<0.05). (2) Microtubules of cells in pH 7.4 group were radially distributed around the nucleus with clear tubular structure. Compared with that in pH 7.4 group, the skeleton of microtubules of cells in pH 6.5 group was obviously damaged, with broken structure of microtubule and reduced density. Compared with that in pH 6.5 group, the damage degree of microtubules of cells in pH 6.5+ taxol group was obviously alleviated, and the structure of microtubules basically returned to normal. (3) Compared with that in pH 7.4 group, the expression of free microtubulin of cells in pH 6.5 group was significantly increased (t=3.030, P<0.05), while the expression of polymerized microtubulin of cells was significantly decreased (t=8.604, P<0.05). Compared with that in pH 6.5 group, the expression of free microtubulin of cells in pH 6.5+ taxol group was significantly decreased (t=4.559, P<0.05), while the expression of polymerized microtubulin of cells was significantly increased (t=5.472, P<0.05). (4) Viability of cells in pH 7.4, pH 6.5, and pH 6.5+ taxol groups were 1.00±0.10, 0.83±0.04, and 0.93±0.10, respectively. Compared with that in pH 7.4 group, the viability of cells in pH 6.5 group was obviously declined (t=4.412, P<0.05). Compared with that in pH 6.5 group, the viability of cells in pH 6.5+ taxol group was obviously increased (t=2.461, P<0.05). Conclusions The decline of pH value reduces the viability of cardiomyocytes of rats through destroying the skeleton of microtubule. Stabilizing microtubule skeleton can significantly reduce acidic treatment-induced damage and ameliorate cardiomyocyte viability.

Advances in the research of antibacterial composite dressings based on bacterial cellulose

Luo Zhenghui, Zhang Jiaping

2018, 34(5): 314-317. doi: 10.3760/cma.j.issn.1009-2587.2018.05.014

Abstract

PDF

Abstract:
Bacterial cellulose (BC) is a promising material for wound dressing due to its predominant water binding capacity, mechanical property, biodegradability, and histocompatibility. Whereas BC itself exhibits no antimicrobial activity. To gain antimicrobial activity, several kinds of antibacterial agents have been introduced into BC. However, all of the antibacterial composite dressings are still in the stage of experimental research. In this paper, the types, antibacterial mechanism, and shortcomings of antibacterial composite dressings based on BC are summarized, in order to make prospects of the research trends of antibacterial composite dressings based on BC in future.

Hemodynamic features and advances in research of goal-directed analgesia for patients with burn shock

Yu Yang, Li Qingdong

2018, 34(5): 318-320. doi: 10.3760/cma.j.issn.1009-2587.2018.05.015

Abstract

PDF

Abstract:
The hemodynamic state of patients with burn shock is extremely unstable. Goal-directed analgesia based on hemodynamic characteristics of different treatment phases is a key point in the treatment of burn shock. This can play active roles in reducing the stress response, decreasing the oxygen consumption, and protecting the organ function. This article reviews the hemodynamic characteristics of burn shock and its need for analgesia in different treatment phases, hoping to provide reference for appropriate analgesia.

2018 Vol. 34, No. 5

Guidelines and Consensus>>

Notice>>