[Shock modeling of large area third-degree burn in miniature swine].

OBJECTIVE: To report a novel method of establishing a stable shock model of swine. METHODS: A total of 12 Guangxi BA-MA female miniature swines (aged 4-6 months) into A and B groups according to a random number table. Total body surface area (TBSA) was calculated according to the Meeb-Rubner formula. After intravenous anesthesia and other steps, solidified gasoline was used as burns material to establish TBSA 40% skin burn (Group A: 45 s, Group B: 50 s). Burn depth by was judged by visual and histopathological examination. Fluid resuscitation was instituted at 2 h post injury. At the same time, the hourly and pre-injury data of heart rate (HR), blood pressure (BP), urinary volume, central venous pressure (CVP) and pulmonary arterial wedge pressure (PAWP) were recorded. The actual input quantities of fluid resuscitation were assessed at the 1st and 2nd 24 h post injury. And shock condition was estimated by shock index at 2 h post injury. RESULTS: All miniature swines were successfully modeled without any mortality. The burn wound observed by visual examination and light microscope showed that Group A was of deep II burn and Group B III burn. Compared with the pre-injury data, HR (111 ± 6 vs 74 ± 9, 119 ± 13 vs 75 ± 13 beats/min) increased, urinary volume (0.99 ± 0.06 vs 1.45 ± 0.05, 0.82 ± 0.04 vs 1.47 ± 0.06 ml×kg(-1)×h(-1)), CVP and PAWP decreased at 2nd 24 h post-injury in two groups (P < 0.01, P < 0.05). But the changes of BP (120 ± 6/93 ± 9 vs 120 ± 6/94 ± 6, 121 ± 15/90 ± 11 vs 124 ± 10/91 ± 8 mm Hg) had no statistical significance (P > 0.05). The average value of HP in 48 h post-injury had no statistical significance in two groups (P > 0.05). The recovery liquid quantity in the first 24 h of Group B (1.66 ± 0.10 ml×kg(-1)×1%(-1) TBSA) was significantly more than Group A (1.53 ± 0.05 ml×kg(-1)×1%(-1) TBSA) (P < 0.05). The ratio between liquid input and output of Groups A and B showed that the comparison had no statistical significance (P > 0.05). In the second 24 h post-injury, the recovery liquid quantity (0.69 ± 0.17, 0.65 ± 0.16 ml×kg(-1)×1%(-1) TBSA) and the ratio between liquid in and out (1.48 ± 0.28, 1.52 ± 0.27)% between Groups A and B had no statistical significance (P > 0.05). The shock index at 2 h post-injury showed that Groups A and B were in shock compensatory period (0.92 ± 0.07) and mild shock state (1.00 ± 0.16) respectively (P > 0.05). CONCLUSION: Such a shock model is stable and dependable.

[Effects of fluid resuscitation programs on the levels of inflammatory mediators during burn shock stage].

OBJECTIVE: To explore the effects of different methods of fluid resuscitation on the levels of inflammatory mediators during burn shock stage. METHODS: Twenty-four miniature swine were numbered from 1 to 24 and randomly divided by EXCEL 2007 into 4 groups of succinylated gelatin, hydroxyethyl starch, Parkland and allogeneic plasma (n = 6 each). Severe burn shock model was established. Succinylated gelatin, hydroxyethyl starch (130/0.4), Ringer's lactate and swine allogenic plasma were used as resuscitation fluid (alternative colloid) according to the burn shock recovery principles (beginning at 2 h post-injury). The parameters of heart rate (HR), blood pressure (BP), urine volume and central venous pressure (CVP) before and within 48 h post-burn were recorded. And the levels of tumor necrosis factor alpha (TNF-α), interleukin (IL) -1ß and IL-8 were measured at the time of pre-injury as well as 4 h, 8 h, 24 h and 48 h post-injury. Statistical analyses were performed. RESULTS: All swine survived the shock stage. TNF-α in succinylated gelatin group was significantly higher at 48 h post-injury than that in allogeneic plasma group ((351 ± 74) vs (215 ± 44) ng/L, P < 0.05). TNF-α in hydroxyethyl starch group was significantly higher at 8 h post-injury than that in allogeneic plasma group ((327 ± 38) vs (249 ± 29) ng/L, P < 0.05). And they were both higher than the pre-burn levels (both P < 0.05). Compared with pre-injury ((508 ± 64) ng/L), the level of IL-1ß in succinylated gelatin group increased substantially at 4 h ((563 ± 76) ng/L), 8 h ((589 ± 76) ng/L) and 48 h ((736 ± 42) ng/L) post-injury (all P < 0.05). The hydroxyethyl starch group was higher at 48 h post-injury than that at pre-injury ((574 ± 72) vs (492 ± 41) ng/L, P < 0.05). Also in Parkland group, the levels were higher at 24 h and 48 h hours post-injury than that at pre-injury ((575 ± 31), (584 ± 65) vs (498 ± 33) ng/L, both P < 0.05). Only succinylated gelatin group was significantly higher (P < 0.01) at 48 h post-injury than allogeneic plasma group ((561 ± 48) ng/L). Compared with pre-injury ((561 ± 48) ng/L), the level of IL-8 in succinylated gelatin group increased significantly at 8 h ((1012 ± 100) ng/L), 24 h post-burn ((993 ± 87) ng/L), significantly higher than allogeneic plasma group ((866 ± 99) ng/L) at 24 h (all P < 0.05). Although hydroxyethyl starch and Parkland groups increased significantly at 4 h post-injury and 8 h, 48 h post-injury versus those at pre-injury (all P < 0.05). There was no significant difference at each time point compared with pre-burn (P > 0.05). CONCLUSIONS: The recovery regimens of hydroxyethyl starch and Parkland groups may restrain the levels of inflammatory mediators. And the effects are similar to those of allogeneic plasma group.

[Characterization and Health Risk of Heavy Metals in PM2.5 from Road Fugitive Dust in Five Cities of Yunnan Province].

In order to study the contents, sources, and health risk of PM2.5 in road fugitive dust in Yunnan, road fugitive dust samples were collected from five typical cities including Kunming, Baoshan, Wenshan, Zhaotong, and Yuxi. Particulate matter resuspension technology was used to levitate the dust samples and collect PM2.5. Eight heavy metals including chromium (Cr), manganese (Mn), nickel (Ni), copper (Cu), zinc (Zn), selenium (As), cadmium (Cd), and lead (Pb) in PM2.5 were detected using ICP-MS. The results showed that the contents of Cr, Ni, Cu, Zn, and Pb in road fugitive dust seriously exceeded the background values of Yunnan soil. The enrichment factors showed that most of the heavy metals in PM2.5 of road fugitive dust in the five cities of Yunnan were moderately enriched and strongly enriched, which were greatly influenced by human activities. The results of correlation analysis and principal component analysis showed that the heavy metals in PM2.5 of road fugitive dust in Yunnan were all affected by soil and traffic sources. The other sources varied greatly in different cities:Kunming was affected by iron and steel melting sources, Baoshan and Yuxi were affected by non-ferrous metal smelting sources, and Zhaotong was affected by coal sources. Health risk analysis showed that Cr, Pb, and As in road fugitive dust PM2.5 had non-carcinogenic risk in children in Kunming, Yuxi, and Zhaotong, respectively, and Cr in Kunming also had a lifetime carcinogenic risk.

Epididymis cell atlas in a patient with a sex development disorder and a novel NR5A1 gene mutation.

This study aims to characterize the cell atlas of the epididymis derived from a 46,XY disorders of sex development (DSD) patient with a novel heterozygous mutation of the nuclear receptor subfamily 5 group A member 1 (NR5A1) gene. Next-generation sequencing found a heterozygous c.124C>G mutation in NR5A1 that resulted in a p.Q42E missense mutation in the conserved DNA-binding domain of NR5A1. The patient demonstrated feminization of external genitalia and Tanner stage 1 breast development. The surgical procedure revealed a morphologically normal epididymis and vas deferens but a dysplastic testis. Microfluidic-based single-cell RNA sequencing (scRNA-seq) analysis found that the fibroblast cells were significantly increased (approximately 46.5%), whereas the number of main epididymal epithelial cells (approximately 9.2%), such as principal cells and basal cells, was dramatically decreased. Bioinformatics analysis of cell-cell communications and gene regulatory networks at the single-cell level inferred that epididymal epithelial cell loss and fibroblast occupation are associated with the epithelial-to-mesenchymal transition (EMT) process. The present study provides a cell atlas of the epididymis of a patient with 46,XY DSD and serves as an important resource for understanding the pathophysiology of DSD.

[Pollution Characteristics and Health Risk of Heavy Metals in Fugitive Dust Around Zhaotong City].

In order to explore the pollution characteristics and health risks of heavy metals in fugitive dust around the urban areas of Zhaotong City, road dust and soil dust samples were collected in the Zhaoyang District of Zhaotong City in May 2019. The dust samples were suspended using a particle resuspension system to obtain PM2.5 (particulate matter with an aerodynamic diameter less than or equal to 2.5 µm). The concentrations of Ca, Al, Fe, Mg, Ti, V, Cr, Mn, Co, Ni, Cu, Zn, As, Cd, and Pb in PM2.5 were quantified by ICP-MS and ICP-OES. By analyzing 10 types of heavy metals in PM2.5, the results showed that the average concentration of Mn was the highest in the soil fugitive dust, followed by Cr, Ni, Zn, Cu, Co, Pb, V, As, and Cd. The average concentration of Zn in the road fugitive dust was the highest, followed by Mn, Cu, Cr, Pb, Ni, As, Co, V, and Cd. The enrichment factor (EF) indicated that Cd was strongly enriched in the two types of fugitive dust. The EFs of Cu, Zn, and Pb in road fugitive dust showed a moderate enrichment, and they were higher than those in soil fugitive dust. Correlation and principal component analysis showed that heavy metals in the two types of fugitive dust were affected by coal burning sources. At the same time, heavy metals in soil fugitive dust were affected by agricultural activity sources, and heavy metals in road fugitive dust were affected by traffic sources. The results of the health risk assessment indicated that the carcinogenic risks of Cr, Co, Ni, As, and Cd in soil fugitive dust were higher than those in road fugitive dust. The non-carcinogenic risks of heavy metals in the two types of fugitive dust for children were higher than those for adults, and the non-carcinogenic risks of Cu, Zn, and Pb in road fugitive dust were higher than those in soil fugitive dust.

[Tangential excision of deep partial thickness burn wound during an early stage without tourniquet].

OBJECTIVE: To explore the clinical efficacy of tangential excision of deep partial thickness burn wound without tourniquet during an early stage. METHODS: A total of 32 patients with a large area of deep partial thickness burn wounds were operated within 24 h post-burn. The lamellar tangential excision was on the basis of stable index of resuscitation from shock without tourniquet. And the depth of tangential excision was achieved to the extent of uniform punctate hemorrhage on burn wounds. Xenogenic acellular dermal matrix was applied after hemostasis with diluted adrenaline. The intraoperative blood loss volumes, operative durations, pre- & post-operative temperatures, length of wound healing, the quality of wound healing and the contracture extent of scars of 1%TBSA (total body surface area) wound were recorded and compared with the published data. RESULTS: Thirty-one patients completed the whole clinical observation. The intraoperative blood loss volume of 1% TBSA wound was (8.8 ± 0.9) ml, the operative duration of 1%TBSA wound was (0.52 ± 0.06) min, the temperature at Day 5 was (37.7 ± 0.7)°C and it was significantly lower than that at 24 h [(38.6 ± 0.6)°C] (t = 0.42, P < 0.05), the length of wound healing was (25.2 ± 2.2) d. There were significantly statistical differences in terms of the operative durations, the temperature at Day 5 and the length of wound healing with the corresponding literature reports with intra-operative uses of tourniquets (all P < 0.05). The percentage of the quality of wound healing was 100% at Month 3. The development of scar proliferation were observed in varying degrees. Mild contracture of wounds appeared after 6 month post-burn. But all joints could move with ease and had no obvious dysfunction. CONCLUSION: Lamellate tangential excision of deep partial thickness burn wound during an early stage without tourniquet have advantages of smaller volumes of intraoperative blood loss, shorter operation duration and simpler procedures. Also the depth of tangential excision is easier to control so as to enhance the quality of wound healing.

[Pollution Characteristics and Health Risk Assessment of Heavy Metals in Road Dust from Non-ferrous Smelting Parks].

In order to explore the pollution characteristics and health risks of heavy metals in dust from roads around non-ferrous smelting activities in different regions, dust samples from urban roads, non-ferrous smelting industry park roads, and tunnel roads were collected from the Mengzi area of Yunnan Province. The dust samples were suspended on Teflon filters by re-suspension equipment to obtain PM2.5 and PM10 samples. Eight heavy metals (Cr, Mn, Ni, Cu, Zn, As, Cd, and Pb) were analyzed by ICP-MS. The results showed that the average content of the total heavy metals in PM2.5 was higher than that in PM10. The average contents of Pb, Cd, As, and Zn were highest in all three types of road dust, and the difference in the total average content in different types of road dust was ranked as:tunnel roads > non-ferrous smelting industrial park roads > urban roads. The average contents of Pb and As in PM2.5 from the tunnel road dust were higher than other heavy metals, and reached up to 92338.3 mg·kg-1 and 12457.7 mg·kg-1, respectively. The average contents of Pb and Zn in PM2.5 from the industrial park road dust were the highest of all heavy metals (4381.7 mg·kg-1 and 4685.0 mg·kg-1, respectively). The average content of Zn and Pb in PM2.5 were the highest of all the heavy metals in the urban road dust (1952.6 mg·kg-1 and 1944.8 mg·kg-1, respectively). The average contents of Cu, Zn, As, Cd, and Pb in the different types of road dust were all higher than their background values in Yunnan Province. The results of the enrichment factor analysis and principal component analysis indicated that Cu, Zn, As, Cd, and Pb were obviously enriched in all three types of road dust, which were significantly affected by the non-ferrous smelting industry and traffic sources. In contrast, Cr, Mn, and Ni were not obviously enriched in the three types of road dust and were less affected by anthropogenic sources. The results of the health risk assessment testified that ingestion was the main exposure route, and that the children's non-carcinogenic risk was higher than that of adults. In PM2.5, As, Cd, and Pb in all types of road dust were associated with non-carcinogenic risks for adults and children. In PM10, As, Cd, and Pb in dust from the non-ferrous smelting industry park roads and tunnel roads had non-carcinogenic risks for humans. As in PM10 from the urban road dust was associated with a non-carcinogenic risk for children, whereas As in dust from the tunnel roads had carcinogenic risks.

1(2,3),2(3,2),3(2,3),4(3,2)-Tetra-kis(1-benzothio-phena)cyclo-tetra-phane benzene sesquisolvate.

In the title compound, C(32)H(16)S(4)·1.5C(6)H(6), the substituted cyclo-octa-tetra-ene (COT) ring compound has approximate local D(2) point symmetry of the so-called 'saddle' form: the dihedral angles between neighboring benzo[b]thio-phene units are 61.33 (4), 61.61 (4), 56.443 (14) and 58.32 (4)°. The short distance [3.545 (1) Å] between an S atom and the centroid of a benzene ring in a neighboring mol-ecule may indicate S⋯π inter-actions in the crystal.

[The relationship between rhGH and blood sugar on different ages of severe degree burned patients].

OBJECTIVE: Probe the effects of rhGH on severe degree burned patients' blood sugar in different age of years. METHODS: Elected 210 patients hospitalized in the Third Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2008, who were burned in 48 h, older than 18 years, ever had no diabetes and tumor history and placidly pull through shock stage. Among the patients there were 132 males and 78 females. The age was from 18 to 65 years old, average (40.7 +/- 7.2) years old. The extent of burn were form TBSA 25% to TBSA 86%, average TBSA (40.4 +/- 12.5)%. The depths of burn were from superficial second degree to third degree. All of the total divided into A (18 - 44 years old) and B (> 45 years old)groups. Each group had 105 patients. Two groups were randomly divided into A(1), A(2), A(0) and B(1), B(2), B(0) groups. Each group had 35 patients. The A(1) and B(1) groups were used 0.15 U/(kg.d) growth hormone (Somatropin, S19990021), A(2) and B(2) groups were used 0.2 U/(kg.d) growth hormone, A(0) and B(0) groups were used NS as control. Observed and analyzed the change of blood sugar and insulin amount used in 210 patients. RESULTS: Of all the patients in 6 groups, there were 190 patients finished the experimentation in four weeks. The insulin amount of A(1), A(2), A(0) groups used were (2123.3 +/- 152.3), (2885.6 +/- 148.5), (724.1 +/- 31.1) U, B(1), B(2), B(0) group were (2715.1 +/- 95.3), (3652.2 +/- 198.1), (801.8 +/- 22.2) U. The consequence showed that the number need insulin to control blood sugar in B group was more than A group, as well as using 0.2 U/(kg.d) does to 0.15 U/(kg.d) does, and using growth hormone to no using(P < 0.01). The time that blood sugar of A(1), A(2), B(1), B(2) group recovered to normal range without using insulin were (5.11 +/- 0.82), (4.93 +/- 0.89), (5.2 +/- 0.65), (5.13 +/- 1.02) d (P > 0.05). CONCLUSIONS: The blood sugar's alteration has positive correlation with the age of years and the does of rhGH. As long as normative using rhGH it doesn't induce diabetes.

[Physico-chemical Characteristic Analysis of PM2.5 in the Highway Tunnel in the Plateau City of Kunming].

This research aimed to determine the characteristics of the motor vehicle exhaust emissions in the plateau area. The PM2.5 was evaluated in the Caohai Tunnel of Kunming for this study by measuring the water-soluble inorganic ions, carbonaceous species, polycyclic aromatic hydrocarbons (PAHs), and inorganic elements in air samples. The results showed that the mass concentration of PM2.5 in the tunnel was about 225.65-312.84 µg·m-3, which is 11-14 times the PM2.5 concentration in the ambient atmosphere. The carbonaceous species were the most abundant species, constituting 35.73% of the total PM2 5 mass, followed by inorganic elements constituting about 21.78% and the water-soluble inorganic ions in the range of 4.79%-5.52%. The smallest proportion of the PM2.5 was PAH, constituting about 0.25%-0.32%. The Ca2+ and SO42- concentrations were the highest among the water-soluble inorganic ions, which accounted for about 77.78%-80.17% of the total ions and from the crust source. NH4+ and NO3- are relatively high, coming mainly from automobile exhausts. The 4 and 6 ring PAHs with higher molecular weight and lower volatility were the dominant components of PM2.5 in the Caohai Tunnel. The automobile exhaust contributing to PAHs in PM2.5 is very significant. The most poisonous single BaP concentration is 23-29 times higher than the state regulations exposure limit, and it has reached a hazardous level. It is obvious that there are health risks from the exposure to PM2.5 in the plateau highway tunnel. A principal component analysis (PCA) showed that the sources of road dust and automobile exhaust emission were about 61.64%, followed by mechanical wear and emissions that accounted for about 17.49% and tire wear emission sources that accounted for 9.11% of the total PM2.5. Under the conditions of hypobaric hypoxia in the Yun-Gui plateau, there is a greater chance of incomplete combustion of motor vehicle fuels, resulting in the increase in OC and PAHs in PM2.5 emissions.

Molecular cloning, sequence analysis, and cadmium stress-rated expression changes of BTG1 in freshwater pearl mussel (Hyriopsis schlegelii).

The B cells translocation gene 1 (BTG1) is a member of the BTG/TOB family of anti-proliferative genes, which have recently emerged as important regulators of cell growth and differentiation among verteates. Here, for the first time we cloned the full-length cDNA sequence of Hyriopsis schlegelii (Hs-BTG1), an economically important freshwater shellfish and potential indicator of environmental heavy metal pollution, for the first time. Using rapid amplification of cDNA ends (RACE) together with splicing the EST sequence from a haemocyte cDNA liary, we found that Hs-BTG1 contains a 525 bp open reading frame (ORF) encoding a 174 amino-acid polypeptide, a 306 bp 5' untranslated region (5' UTR), and a 571 bp 3' UTR with a Poly(A) tail as well as a transcription termination signal (AATAAA). Homologue searching against GenBank revealed that Hs-BTG1 was closest to Crassostrea gigas BTG1, sharing 50.57% of protein identities. Hs-BTG1 also shares some typical features of the BTG/TOB family, possessing two well-conserved A and B boxes. Clustering analysis of Hs-BTG1 and other known BTGs showed that Hs-BTG1 was also closely related to BTG1 of C. gigas from the inverteate BTG1 clade. Function prediction via homology modeling showed that both Hs-BTG1 and C. gigas BTG1 share a similar three-dimensional structure with Homo sapiens BTG1. Tissue-specific expression analysis of the Hs-BTG1 via real-time PCR showed that the transcripts were constitutively expressed, with the highest levels in the hepatopancreas and gills, and the lowest in both haemocyte and muscle tissue. Expression levels of Hs-BTG1 in hepatopancreas (2.03-fold), mantle (2.07-fold), kidney (2.2-fold) and haemocyte (2.5-fold) were enhanced by cadmium (Cd²âº) stress, suggesting that Hs-BTG1 may have played a significant role in H. schlegelii adaptation to adverse environmental conditions.

Effect of artificial colloids on blood coagulation during shock stage of severe burn injury.

BACKGROUND: There are controversies about the use of artificial colloids. This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury. METHODS: Totally, 18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia. Resuscitation therapy was applied 2 hours after the injury, using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of burns. The Ba-Ma mini-pigs were randomly assigned to three groups (six pigs in each group): succinylated gelatin group (the artificial colloid used was succinylated gelatin Injection), hydroxyethyl starch group (the artificial colloid used was hydroxyethyl starch (130/0.4)), and allogeneic plasma group (the colloid used was allogeneic plasma). Blood samples were collected from the animals prior to the burn injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The platelet count (PLT), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and fibrinogen (Fib) were measured, followed by a statistical analysis of all results. RESULTS: The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were (124.3 ± 52.7), (78.8 ± 16.4) × 10(9)/L and (159.0 ± 62.8), (87.3 ± 32.0)× 10(9)/L respectively. But in the allogeneic plasma group at intervals of 8, 24, and 48 hours were (234.3 ± 52.6), (136.0 ± 47.4), (75.8 ± 31.0) × 10(9)/L. The decrease were all statistically significant (P < 0.05, P < 0.01) when compared to pre-burn ((383.3 ± 77.9), (382.7 ± 65.7), (381.0 ± 49.4)× 10(9)/L). The PLT among the three groups, at all the time points, had no statistical difference (P > 0.05). Compared to pre-burn ((10.8 ± 0.9), (11.4 ± 0.8), (10.6 ± 0.7) seconds), the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (14.5 ± 1.5) and (16.2 ± 1.3) seconds, whereas in the allogeneic plasma group at 8 and 24 hours the PT were (13.0 ± 0.9) and (14.5 ± 1.5) seconds, i.e., an increase in the statistical significance (P > 0.01). Statistical significance was observed at 8 and 48 hours between the succinylated gelatin group and hydroxyethyl starch group, and at 48 hours between the hydroxyethyl starch and allogeneic plasma group (P < 0.05). The INR at 24 hours were (1.26 ± 0.13) in the succinylated gelatin group, (1.40 ± 0.11) in the hydroxyethyl starch group, and (1.13 ± 0.07) and (1.26 ± 0.13) at 8 and 24 hours in the allogeneic plasma group. When compared with pre-burn ((0.94 ± 0.08), (0.99 ± 0.07), and (0.92 ± 0.06) seconds), the other groups have increased significantly (P > 0.01). The comparison at 8 and 48 hours between the succinylated gelatin group and the hydroxyethyl starch group, at 48 hours between hydroxyethyl starch group and allogeneic plasma group showed statistical difference (P < 0.01). The APTT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (13.1 ± 1.1) and (14.6 ± 2.9) seconds. The APTT of the allogeneic plasma group at 4, 8 and 24 hours were (10.9 ± 1.4), (11.8 ± 1.1), and (13.7 ± 1.5) seconds. Compared to pre-burn ((11.5 ± 4.2), (11.2 ± 3.3), (10.1 ± 1.4) seconds), they were statistically significant (P < 0.05). There was no statistical difference in the APTT between the three groups, at all the time points. The Fib of the succinylated gelatin group at 24 and 48 hours were (4.3 ± 0.3) and (4.7 ± 0.2) g/L, (4.1 ± 0.3), and (5.0 ± 0.1) g/L in allogeneic plasma group, and at 8, 24, and 48 hours the Fib for the hydroxyethyl starch group was (2.9 ± 0.4), (4.0 ± 0.5), and (4.6 ± 0.6) g/L. Compared to pre-burn ((2.4 ± 0.2), (2.5 ± 0.3), (2.6 ± 0.5) g/L), they were all statistically significant (P < 0.01). There was no statistical difference in APTT between the three groups, at all time points. CONCLUSION: The changes of the indices in blood coagulation during the shock phase of a severe burn injury correlate with the stress response to the burn, rather than to the application of HES (130/0.4) and succinylated gelatin.

[Effects of resuscitation with different kinds of colloids on pulmonary edema in swine in shock stage of severe burn injury].

OBJECTIVE: To observe and compare the effects of natural colloid and artificial colloid on pulmonary edema of swine during shock stage of severe burn injury. METHODS: Twelve Guangxi Bama miniature swine were inflicted with 40% TBSA full-thickness burn on the back, and then they were divided into natural colloid group (N) and artificial colloid group (A) according to the random number table, with six swine in each group. At post injury hour (PIH) 2, fluid resuscitation was begun. The main part of electrolyte was lactic acid Ringer's solution. The colloids included swine plasma and hydroxyethyl starch 130/0.4. Before injury and at every hour within PIH 48, heart rate, blood pressure, urine volume, central venous pressure (CVP), and pulmonary arterial wedge pressure (PAWP) were recorded. The mean heart rate, blood pressure, urine volume per hour per kg of body weight, CVP, PAWP, resuscitation liquid volume, and the ratio of fluid intake to output during the first and second PIH 24 were calculated. At PIH 48, lung tissue was harvested for histopathological observation and calculation of lung water ratio. Data were processed with one-way analysis of variance, analysis of variance of repeated measurement, LSD test and independent sample t test. RESULTS: (1) There were no statistically significant differences between two groups in heart rate, blood pressure, and urine volume before injury and during the first and second PIH 24 (P values all above 0.05); during the first PIH 24, the CVP and PAWP of group A were significantly higher than those of group N (P values all below 0.05). Compared with those before injury, the heart rate, CVP and PAWP of two groups during the first and second PIH 24 were significantly higher (P < 0.05 or P < 0.01); the urine volume of group N was decreased during the first PIH 24 (P < 0.05), while there was no significant change in group A (P > 0.05); the urine volumes of two groups during the second PIH 24 were increased, while no statistically significant differences were observed (P values all above 0.05). There were no statistically significant differences in blood pressure of two groups between the first, second PIH 24 and before injury (P values all above 0.05). (2) There were no statistically significant differences in the resuscitation liquid volume and fluid intake to output ratio between two groups during the first and second PIH 24 (P values all above 0.05). (3) The alveolar septum was found widened in varying degrees, and there were edema fluid accumulating and inflammatory cell infiltrating within the pulmonary interstitial of lung tissue sections in both two groups. (4) The lung water ratio of group N [(71 ± 10)%] was not statistically significant different from that of group A [(79 ± 4)%, t = -1.753, P > 0.05]. CONCLUSIONS: The natural colloid or artificial colloid (hydroxyethyl starch 130/0.4) applied during shock stage had similar effects on pulmonary edema in swine with severe burn.

[Comparison among several foam dressings in the properties of water-absorption, water-locking and air permeability].

OBJECTIVE: To compare the properties of water-absorption, water-locking, and air permeability among several foam dressings, and to provide references for clinician in choosing dressings for different types of wounds. METHODS: The comparison was made among Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing that were commonly used in clinic. NaCl and CaCl2·H2O respectively in the weight of 8.3 g and 0.367 g were diluted with distilled water to the volume of 1 L to simulate wound exudation. The simulated wound exudation was used to test the water-absorbing rate of dressings at post immersion hour (PIH) 24, water-absorbing speed of dressings at post immersion minute (PIM) 1, 5, 10, and 20, the diffusion diameter of exudation dripped on the surface of dressings for 5 min to reflect the water-locking capacity of dressings, and the water evaporation capacity of exudation after being sealed up by dressings for 24 h to reflect the air permeability of dressings. Five samples of each dressing were used for each index. Data were processed with one-way analysis of variance and analysis of variance of repeated measurement, and LSD method was applied in paired comparison. RESULTS: (1) The water-absorbing rate at PIH 24 of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (646 ± 18)%, (616 ± 19)%, and (499 ± 11)% (F = 423.854, P < 0.01). The differences between each two dressings in water-absorbing rate were statistically significant (with P values all below 0.01). (2) The water-absorbing speed of Allevyn foam dressing at PIM 1, 5, 10, and 20 were (35.20 ± 2.31), (12.48 ± 0.37), (6.63 ± 0.23), and (3.39 ± 0.08) g×s(-1)×m(-2), which were obviously lower than those of Mepilex foam dressing [(119.68 ± 2.59), (24.39 ± 0.62), (12.33 ± 0.29), and (6.18 ± 0.13) g×s(-1)×m(-2)] and Biatain foam dressing [(121.09 ± 3.41), (24.73 ± 0.52), (12.37 ± 0.25), (6.18 ± 0.13) g×s(-1)×m(-2)], with P values all below 0.01. The water-absorbing speed of each dressing showed the trend of declination among three dressings with prolongation of time. The differences between two adjacent time points within each dressing in water-absorbing speed were statistically significant (with P values below 0.01). (3) Diffusion diameters of exudation dripped on the surface of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (5.66 ± 0.15), (4.84 ± 0.15), (3.94 ± 0.21) cm (F = 124.742, P < 0.01). The differences between each two of the three dressings in diffusion diameter were statistically significant (with P values all below 0.01). (4) The water evaporation capacity of exudation after being sealed up by each dressing for 24 h decreased in succession for Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing, which were respectively (31.2 ± 3.1), (29.7 ± 8.7), (5.6 ± 2.8) g×h(-1)×m(-2) (F = 24.324, P < 0.01). The water evaporation capacity of exudation sealed with Biatain foam dressing was significantly lower than that of exudation sealed with Allevyn foam dressing and Mepilex foam dressing (with P values below 0.01). CONCLUSIONS: Among the three kinds of foam dressings, Allevyn performs best in water-absorbing rate, water-locking capacity, and air permeability, while Mepilex and Biatain perform best in water-absorbing speed. For selecting foam dressing in clinic, the properties of foam dressings and wound characteristics should be considered at the same time.

[Characterization of atmospheric volatile organic compounds in Shenyang, China].

From April, 2008 to July, 2009, 187 atmospheric samples in four different seasons were collected from five sites in Shenyang. The 108 species of VOCs were measured by using the method of pre-concentration-GC-MS. The objectives of this study were to investigate the VOCs pollution level as well as its spatial and temporal distribution, and to identify the main source in Shenyang city. The results showed that the average total mass concentration of VOCs in Shenyang was 371.0 +/- 132.4 microg/m3. The major components were oxygen-containing compounds, halogenated hydrocarbon, alkanes, aromatics and alkenes, which accounted for 57.2%, 20%, 11.4%, 8.5%, and 3.0% of the total mass, respectively. A seasonal variation of VOCs across all the sampling sites was observed, with higher levels in spring and autumn and lower levels in winter and summer. Related with industrial emission, the diurnal variation of the total mean VOCs concentrations at downtown site showed three peaks in winter and two peaks in summer. The VOCs levels in the industrial and downtown areas were higher than those in other areas, with the lowest concentration observed at clean air site with no emission source around. From the results of correlation analysis and concentration ratios analysis, the VOCs pollutants in Shenyang were mainly contributed by automobile exhaust, coal & biofuel combustion, gasoline & solvent evaporation and industrial process.

[Evaluation of the clinical curative effect of applying vacuum sealing drainage therapy in treating deep partial-thickness burn wound at the initial stage].

OBJECTIVE: To evaluate the clinical curative effect of applying vacuum sealing drainage (VSD) therapy in treating deep partial-thickness burn wound at the initial stage prospectively, and to provide the basis for its clinical application. METHODS: Twenty-two patients with about 10% TBSA burn of the lower limbs, and in which partial-thickness wound exceeded 1% TBSA in each limb, were admitted to our hospital within 3 hours after burn from May 2009 to March 2010. Wounds in each patient were divided into VSD treatment group (treated with VSD therapy) and control group (treated with 10 g/L silver sulfadiazine cream) based on the principles of symmetry of location, identical deepness, and similarity in size etc. The amount of water evaporation, the swelling intensity, the status of bacterial colonization, the degree of pain, the healing time, and the quality of healing of wounds in 2 groups were observed and compared. Data were processed with t test and rank-sum test. RESULTS: The observation was completed in 21 patients. All of the wounds were treated within 4 hours post burn (PBH). The amount of water evaporation of the normal skin and burn wounds before dressing coverage in VSD treatment group was respectively close to that in control group (with t value respectively 1.310, -0.911, P values all above 0.05); the amount of water evaporation on the surface of dressing in VSD treatment group [(44.3+/-3.9) mLxh(-1)xm(-2)] was less than that in control group [(66.1+/-6.4) mLxh(-1)xm(-2), t=-11.39, P<0.01]. In VSD treatment group, the circumference of proximal thigh increased (3.48+/-0.35) and (2.51+/-0.21) cm on post burn day (PBD) 3, 7 as compared with that on PBH 5, which was respectively smaller than that [(8.02+/-0.41), (3.99+/-0.32) cm] in control group (with t value respectively 4.110, 3.569, P values all below 0.01). Positive bacteria' culture rate on PBD 10 of each group was respectively lower than that at admission (with Z value respectively -3.220, -3.870, P values all below 0.01), and there was no significant statistical difference between 2 groups at admission or on PBD 10 (with Z value respectively -0.894, 0.000, P values all above 0.05). The wound surface in VSD treatment group was weak acidic (pH value 7.12+/-0.06) on PBD 10, and it was neutral (pH value 7.41+/-0.13) in control group. The wound pain degree in control group on PBD 1, 3, 7 was respectively higher than that in VSD treatment group (with t value respectively -16.132, -21.230, -16.453, P values all below 0.01). There was no significant statistical difference between 2 groups in healing time of wounds (t=1.186, P>0.05). The healing quality of wounds in VSD treatment group (100.00%, 100.00%) 2 or 3 months after burn was better than that in control group (19.05%, 85.71%) (with Z value respectively -11.638, -3.870, P values all below 0.01). CONCLUSIONS: Early application of VSD therapy cannot expedite the healing process of deep partial-thickness burn wounds, but it can improve the healing quality. It is one of the effective methods to deal with deep partial-thickness burn wounds, which is worthy of clinical attention and further research.

[Effect of different dressing materials in various combinations on wound microenvironment of donor site in burn patients].

OBJECTIVE: To investigate the effect of dressing materials in various combinations on burn wound microenvironment and healing condition. METHODS: Two hundred donor sites with wounds of 0.3 mm in depth in 186 burn patients, who needed skin grafting and admitted to our ward were enrolled in study, and they were divided into A (with dressing composed of alginate + cotton pad for donor area), B (with dressing composed of vaseline gauze + cotton pad for donor area), C (with dressing composed of alginate + foam dressing for donor area), D (with dressing composed of vaseline gauze + foam dressing for donor area) groups according to random table method. Effect of dressings on wound evaporation and pH value were observed. Bacterial colonization, degree of pain complained by patients after dressing change, and wound healing time in each group were compared. RESULTS: One hundred and eighty-four patients complied with the study, while 2 patients were excluded due to untimely falling-off of the dressing. Wound evaporation in A, B, C, D groups was (35.5 +/- 3.2), (31.3 +/- 2.8), (23.1 +/- 2.9), (18.1 +/- 2.3) mL x h(-1) x m(-2) respectively, among them B group showed optimal effect of keeping humidity (P < 0.01). Wound pH value in A, B, C, D groups was 7.22 +/- 0.06, 7.41 +/- 0.03, 7.05 +/- 0.03, 7.34 +/- 0.06, respectively, among them it was highest in B group. The positive rate of bacteria in D group was highest (22.4%), and lowest in C group (4.0%). Pain was lightest in C group (score was 0.98 +/- 0.12), and most serious in B group (score was 8.14 +/- 0.82). The shortest wound healing time was seen in C group (6.7 +/- 0.8 d), and longest in D group (15.6 +/- 3.5 d). CONCLUSIONS: Application of various dressings on similar wounds can produce different wound microenvironment, which is closely related to wound healing time. Compared with pH value, humidity is the more important factor for wound healing.

Combination of compound Xuanju Capsule and sildenafil for erectile dysfunction that progressively fails to respond to sildenafil / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the clinical effects of Compound Xuanju Capsule (CXC) combined with sildenafil on erectile dysfunction (ED) that progressively fails to respond to sildenafil.</p><p><b>METHODS</b>Totally, 36 ED patients who progressively failed to respond to sildenafil were randomly divided into a trial and a control group of equal number, the former treated with oral CXC at 3 g tid plus sildenafil at 50 mg an hour before sexual activity, while the latter with sildenafil alone at 100 mg an hour before sexual activity. After 2 months of treatment, we compared the patients' scores on IIEF-5 and their partners' scores on Treatment Satisfaction Scale (TSS) between the two groups.</p><p><b>RESULTS</b>The total rate of erectile function improvement was 94.44% in the trial and 88.89% in the control group (P > 0.05). The IIEF-5 score was 20.888 9 +/- 3.833 1 in the former and 18. 777 8 +/- 4.008 2 in the latter after treatment, significantly higher than 13. 166 7 +/- 3.601 5 and 13. 055 6 +/- 2.775 4 before treatment (P < 0.05). The post-treatment IIEF-5 scores of the patients and the TSS scores of their partners were markedly higher in the trial than in the control group (P < 0.05).</p><p><b>CONCLUSION</b>Compound Xuanju Capsule combined with sildenafil is effective for erectile dysfunction that progressively fails to respond to sildenafil.</p>

Application of tubularized incised plate in one-stage urethroplasty for hypospadia accompanied with anatomic kak-factors / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the application of tubularized incised plate (TIP) in urethroplasty for hypospadia accompanied with anatomic kak-factors.</p><p><b>METHODS</b>We retrospectively studied 191 cases of hypospadia treated by one-stage TIP urethroplasty. Taking the position of the urinary meatus, the development of the glans penis and urethral plate, and the degree of penile ventral curvature as anatomic kak-factors inducing postoperative complications and affecting the appearance, we conducted correlation analyses on the clinical effects of the procedure using SPSS 10.0 statistics.</p><p><b>RESULTS</b>Postoperative complications were closely correlated with the position of the urinary meatus, the nearer its position to the coronary sulcus, the higher the incidence of complications (chi2 = 24.291, P < 0.01). And so were they with the development of the glans penis and urethral plate and the degree of penile ventral curvature. The incidence of postoperative complications was significantly higher in the hypospadia patients with small glans, maldeveloped urethral plate and severe penile ventral curvature than in those with straight penis and well-developed glans and urethral plate (chi2 = 25.419, P < 0.01).</p><p><b>CONCLUSION</b>Tubularized incised plate urethroplasty for hyper-spadias should be chosen according to the position of the meatus, the development of urethral mucous membrane, the degree of ventral curvature and surgery experience in order to achieve a high cure rate and good cosmetic effect.</p>