Observation on the fluid resuscitation and the change in blood sodium of severely burned patients in the early stage / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the necessary amount of fluid consisting of electrolyte and colloid, the ratio of electrolyte and colloid used, and the change of blood sodium during early resuscitation in severely burned patients.</p><p><b>METHODS</b>Sixty-seven patients with total burn surface area (TBSA) equal to or over 70% and full-thickness area equal to or over 50%TBSA, hospitalized from March 2004 to March 2009, were resuscitated with fluid. The infusion amount of electrolyte, colloid, and water, and urinary output of patients at post injury hour (PIH) 24, 48, and 72 were analyzed retrospectively. The variation in blood sodium and fluid infusion at different time points was recorded. Data were processed with SPSS 13.0 software.</p><p><b>RESULTS</b>Among the 67 patients, hyponatremia occurred in 9 cases, hypernatremia occurred in 5 cases, and 53 patients had normal blood sodium level. The urinary output of patients within PIH 72 was above 70 mL/h. K value was calculated through the formula: actual total infusion amount of electrolyte and colloid (mL) = burn area (%TBSA) x body weight (kg) x K. In the first 24 PIH, K value was about 1.7, and the ratio of electrolyte and colloid was 1.4. In the second 24 PIH, K value was about 1.3 with electrolyte and colloid ratio 1.6. K value in the third 24 PIH was about 0.9 with electrolyte and colloid ratio 2.0.</p><p><b>CONCLUSIONS</b>The actual amount of resuscitation fluid is slightly larger than that calculated from traditional formula during the early stage in severely burned patients. The amount of electrolytes and the proportion of electrolyte and colloid will influence blood sodium level of patients.</p>

Influence of vacuum-assisted closure technique on expression of Bcl-2 and NGF/NGFmRNA during wound healing / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the influence of vacuum-assisted closure technique (VAC) on expression of Bcl-2 and NGF during wound healing.</p><p><b>METHODS</b>Eighty Sprague-Dawley rats were randomly divided into 4 groups with 20 rats of each. Group T was the experimental group; group C1, C2 and C3 were the control groups. In group T and group C1, capsaicin was injected subcutaneously to the back of the rats to destroy the sensory nerve. VAC was employed to the wound of the rats in group T and C2 three times a day at 80 mmHg negative pressure. In all the groups, tissue samples were taken from the wound edge and granulation at 1, 3, 6, 9 and 12 days after the injury. Immunohistochemistry and in situ hybridization were used to detect the expression of Bcl-2 and NGF/NGFmRNA in the samples.</p><p><b>RESULTS</b>In group C2 and C3, the expression of Bcl-2 and NGF/NGFmRNA was obvious, which increased gradually and reached the peak at the 9th day. In the process of wound healing, the expression Bcl-2 and NGF/NGFmRNA was higher in the group C2 than in group C3 (P < 0.05). The expression Bcl-2 and NGF/NGFmRNA in group T and C1 was lower than group C2 and C3 (P < 0.05).</p><p><b>CONCLUSION</b>The application of the vacuum-assisted closure technique during wound healing increases the expression of the apoptosic modulation related protein Bcl-2 and affects the expression of NGF/NGFmRNA, which may promote the wound healing process.</p>