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Objective evaluation of burn and post-surgical scars and the accuracy of subjective scar type judgment

Chinese Medical Journal 2008年第24期121卷 2517-2520页

作者： WANG Zhi-yong ZHANG Jian LU Shu-liang Shanghai institute of bums Department of bums Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background The true proliferation degree of burn and operation scars during their maturation was poorly defined. The objective of this study was to provide a quantitative evaluation of the proliferation degree of deep-partial thickness burn and surgical suture wound scars after wound healing and the accuracy of subjective judgment of scar types. Methods A total of 423 patients in the burn group and 667 patients in the suture wound group were enrolled in this study. Objective scar measurement （by negative-positive moulage） was carried out at 3, 6 and 12 months after wound healing in 1090 patients from different regions in China. The Kruskal-Wallis H test and chi-square test were used in the statistical analysis. Results The median degrees of scar proliferation were 0.03 cm at 3 months, 0.03 cm at 6 months and 0 cm at 12 months in the burn group and 0.05 cm, 0.04 cm and 0.04 cm respectively in the suture wound group. At 3 and 6 months post wound healing, there was no significant difference in scar proliferation between the groups （P 〉0.01）. After 1 year, burn scars displayed evidence of atrophy （P 〈0.01）. Although the degree of scar proliferation differed among the four scar types （P 〈0.01）, the ranges of scar height in the four scar types largely overlapped when judged in a subjective manner, especially in proliferation and superficial scars. Conclusions Scar atrophy occurs after one year in burns, but not in the surgical suture wound group. It is important to take anti-scar therapy for surgical wounds as well as burn wounds. The various scar types could not be judged precisely in a subjective manner.

关键词： cicatrix burns surgery quantitative evaluation

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Research advances in pericyte function and their roles in diseases

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Chinese Journal of Traumatology 2020年第2期23卷 89-95页

作者： Zi-Sen Zhang He-Nan Zhou Shuang-Shuang He Ming-Ying Xue Tao Li Liang-Ming Liu State Key Laboratory of Trauma Bums and Combined InjuryResearch Institute of SurgeryDoping HospitalArmy Medical UniversityChongqing 400042China

Pericyte,a kind of pluripotent cell,may regulate the irigation flow and permeability of *** are similar to the smooth muscle cells,which express several kinds of contractile proteins and have *** dysfunction of pericytes is related to many microvascular diseases,including hypoxia,hypertension,diabetic retinopathy,fibrosis,inflammation,Alzheimer's disease,multiple scle-rosis,and tumor *** a long time,their existence and function have been *** distribution,structure,biomarker,related signaling pathways as well as the roles of pericytes on vascular diseases will be introduced in this review.

关键词： Pericytes Vascular diseases Microcirculation

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The past and present of blast injury research in China

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Chinese Journal of Traumatology 2015年第4期18卷 194-200页

作者： Yan Zhao Yuan-Guo Zhou Molecular Biology Center State Key Laboratory of Trauma Bums and Combined Injury Research Institute of Surgery and Daping Hospital Third Military Medical UniversityChongqing 400042 China

With the increasing incidence of blast injury, the research on its mechanisms and protective measures draws more and more attention. Blast injury has many characteristics different from general war injuries or trauma. For example, soldiers often have various degrees of visceral injury without significant surface damage, combined injuries and arterial air embolism. Researchers in China began to investigate blast injury later than the United States and Sweden, but the development is so fast that lots of achievements have been gained, including the development of biological shock tube, the mechanisms and characteristics of blast injury in various organs, as well as protective measures under special environments. This article reviews the past and current situation of blast injury research in China.

关键词： Blast injury Shock tube Blast wave

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X-ray observation on how axial compression stimulates tibial fracture healing

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Chinese Journal of Traumatology 2010年第6期13卷 323-328页

作者：陈海斌王正国肖凯初同伟邱俊张良周继红 State Key Laboratory of Trauma Bums and Combined Injuries Institute of Surgery Research Daping HospitalThird Military Medical University Chongqing 400042 China

Objective： To validate the hypothesis that there exists an optimal axial compression stress range to enhance tibial fracture ***： Rabbits with a surgically induced V-shaped tibial fracture were separated into 2 main groups： the control group （C Group, n=6） without application of any axial compression stress stimulation postoperatively and the stimulation group （ S Group, n=90）. The S Group was further divided into 20 subgroups （S11 to S54） in terms of 5 axial compression stress stimulation levels （112.8 kPa, 289.8kPa, 396.5 kPa, 472.7 kPa, and 602.3 kPa） and 4 experimental endpoints （1, 3, 5 and 8 weeks after operation）. A custom made circular external fixator was used to provide the axial compression stress of the fracture sites. Based on X-ray observation, a fracture healing scoring system was created to evaluate the fracture healing ***： At 8 weeks after operation, there existed a ＂⌒-shape＂ relationship between healing score and axial compression stress stimulation level of fracture site. The optimal axial compression stress stimulation ranged from 289.8 kPa to 472.7 kPa, accompanying the best fracture healing, i.e. the fracture line became indistinct or almost disappeared, and a lot of callus jointed the two fracture ends. Meanwhile, at 5 weeks after operation, corresponding to the relatively low healing scores, there was a fracture healing performance similar to that at 8 weeks. Besides, at 1 or 3 weeks after operation, for all the axial compression stress levels （0-602.3 kPa）, no obvious healing effect was ***： It is implied from the stated X-ray observation results in this study that the potential optimal axial compression stress stimulation and optimal fracture healing time are available. The axial compression stress level of 289.8-472.7 kPa and fracture healing time of more than 8 weeks jointly comprise the optimal axial compression stress stimulation conditions to enhance tibial fracture healing.

关键词： Tibia Fracture healing Stress,mechanical Tomography, X-ray External fixators

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Surgical treatment strategy for multiple injury patients in ICU

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Chinese Journal of Traumatology 2011年第1期14卷 42-45页

作者： ZHANG Lian-yang YAO Yuan-zhang JIANG Dong-po ZHOU Jian HUANG Xian-kai SHEN Yue HUANG Jian State Key Laboratory of Trauma Bums and Combined Injury Trauma Center of PLA Institute of Surgery ResearchDaping Hospital Third Military Medical UniversityChongqing 400042 China

Objective： To investigate the surgical treatment for patients with multiple injuries in ***： Clinical data of 163 multiple injury patients admitted to ICU of our hospital from January 2006 to January 2009 were retrospectively studied, including 118 males and 45 females, with the mean age of 36.2 years （range, 5-67 years）. The injury regions included head and neck （29 cases）,face （32 cases）, chest （89 cases）, abdomen （77 cases）, pelvis and limbs （91 cases） and body surface （83 cases）. There were 57 cases combined with shock. ISS values varied from 10 to 54, 18.42 on average. Patients received surgical treatments in ICU within respectively 24 hours （10 cases）, 24-48 hours （8 cases）, 3-7 days （7 cases） and 8-14 days （23 cases）.Results： Forthe 163 patients, the duration of ICU stay ranged from 2 to 29 days, with the average value of 7.56 days. Among them, 143 were cured （87.73%）, 11 died in the hospital （6.75%） due to severe hemorrhagic shock （6 cases）,craniocerebral injury （3 cases） and multiple organ failure （2 cases）, and 9 died after voluntarily discharging from hospital （5.52%）. The total mortality rate was 12.27%.Conclusions： The damage control principle should be followed when multiple injury patients are resuscitated in ICU. Surgical treatment strategies include actively controlling hemorrhage, treating the previously missed injuries and related wounds or surgical complications and performing planned staging operations.

关键词： Surgery Multiple trauma Intensive care units

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Review of Chinese Journal of Traumatology in the year 2018

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Chinese Journal of Traumatology 2019年第1期22卷 21-23页

作者： Yuan Tian Gui-E Liu Wen-Jun Zhao Yuan-Yuan Peng Shuang-Ming Song Lei Li State Key Laboratory of Trauma Bums and Combined Injury Research Institute of Surgery/Daping Hospital Third Military Medical University Chongqing 400042 China

Trauma is one of the leading causes of death worldwide. It is an urgent task to strengthen the trauma care and prevenr related complications. In 2018, Chinese Journal of Traumatology reported a series of trauma-related articles which cover the contents of pre-hospital care, in-hospital care, complication prevention, etc. The journal aims to improve the treatment levels, decrease the trauma incidence, and reduce the trauma mortality and disability.

关键词： Chinese Journal Traumatology

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Carbon liberated from CO-releasing molecules attenuates leukocyte infiltration in the small intestine of thermally injured mice

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World Journal of Gastroenterology 2007年第46期13卷 6183-6190页

作者： Bing-Wei Sun Qin Jin Yan Sun Zhi-Wei Sun Xi Chen Zhao-Yong Chen Gediminas Cepinskas Department of bums and Plastic Surgery AffiliatedHospital Jiangsu University Zhenjiang 212001 Jiangsu ProvinceChina Centre for Critical Illness Research Lawson HealthResearcia Institute 800 Commissioners Rd. E.London Ontario N6A 4G4 Canada

AIM： To determine whether Carbon （CO） liberated from CO-releasing molecules attenuates leukocyte infiltration in the small intestine of thermally injured mice. METHODS： Thirty-six mice were assigned to four groups. Mice in the sham group （n = 9） were underwent to sham thermal injury; mice in the burn group （n = 9） received 15% total body surface area full-thickness thermal injury; mice in the burn ＋ CORM-2 group （n = 9） were underwent to the same thermal injury with immediate administration of tricarbonyldichlororut henium （11） dimer CORM-2 （8 mg/kg, i.v.）; and mice in the burn＋DMSO group （n = 9） were underwent to the same thermal injury with immediate administration of 160 IJL bolus injection of 0.5% DMSO/saline. Histological alterations and granulocyte infiltration of the small intestine were assessed. Polymorphonuclear neutrophil （PMN） accumulation （myeloperoxidase assay） was assessed in mice mid-ileum. Activation of nuclear factor （NF）-KB, expression levels of intercellular adhesion molecule-1 （ICAM-1） and inducible heme oxygenase in mid-ileum were assessed. RESULTS： Treatment of thermally injured mice with CORM-2 attenuated PMN accumulation and prevented activation of NF-kB in the small intestine. This was accompanied by a decrease in the expression of ICAM-1. In parallel, burn-induced granulocyte infiltration in mid- ileum was markedly decreased in the burn mice treated with CORM-2. CONCLUSION： CORM-released CO attenuates leukocyteinfiltration in the small intestine of thermally injured mice by interfering with NF-KB activation and protein expression of ICAM-1, and therefore suppressing the pro-adhesive phenotype of endothelial cells.

关键词： Leukocyte infiltration Carbon monoxide Thermal injury Small intestine

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Neuronal Activity in the Cerebellum During the Sleep-Wakefulness Transition in Mice

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Neuroscience Bulletin 2020年第8期36卷 919-931页

作者： Li-Bin Zhang Jie Zhang Meng-Jia Sun Hao Chen Jie Yan Fen-Lan Luo Zhong-Xiang Yao Ya-Min Wu Bo Hu Department of Physiology College of Basic Medical SciencesArmy Medical UniversityChongqing 400038China State Key Laboratory of Trauma Bums and Combined InjuryDaping Hospital/Research Institute of SurgeryArmy Medical UniversityChongqing 400042China Squadron 10 Battalion 3College of Basic Medical SciencesArmy Medical UniversityChongqing 400038China

Cerebellar malfunction can lead to sleep disturbance such as excessive daytime sleepiness,suggesting that the cerebellum may be involved in regulating sleep and/or ***,understanding the features of cerebellar regulation in sleep and wakefulness states requires a detailed characterization of neuronal activity within this *** performing multiple-unit recordings in mice,we showed that Purkinje cells(PCs)in the cerebellar cortex exhibited increased firing activity prior to the transition from sleep to ***,the increased PC activity resulted from the inputs of lowfrequency non-PC units in the cerebellar ***,the increased PC activity was accompanied by decreased activity in neurons of the deep cerebellar nuclei at the nonrapid eye-movement sleep-wakefulness *** results provide in vivo electrophysiological evidence that the cerebellum has the potential to actively regulate the sleep-wakefulness transition.

关键词： Sleep Wakefulness Multiple-unit recording Purkinje cell Deep cerebellar nuclei

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Characteristics of and strategies for patients with severe burn-blast combined injury

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Chinese Medical Journal 2007年第20期120卷 1783-1787页

作者： CHAI Jia-ke SHENG Zhi-yong LU Jiang-yang WEN Zhong-guang YANG Hong-ming JIA Xiao-ming LI Li-gen CAO Wei-hong HAO Dai-feng SHEN Chuan-an TUO Xiao-ye LIANG Li-ming WANG Shu-jun bums institute First Hospital Affiliated to the General Hospital of People＇s Liberation Army Beijing 100037 China Department of Pathology First Hospital Affiliated to the General Hospital of People＇s Liberation Army Beijing 100037 China Department of Respiratory Medicine First Hospital Affiliated to the General Hospital of People＇s Liberation Army Beijing 100037 China

Background Severe burn-blast combined injury is a great challenge to medical teams for its high mortality. The aim of this study was to elucidate the clinical characteristics of the injury and to present our clinical experiences on the treatment of such cases.Methods Five patients with severe bum-blast combined injuries were admitted to our hospital 77 hours post-injury on June 7, 2005. The burn extent ranged from 80% to 97% （89.6%±7.2%） of TBSA （full-thickness burns 75%-92% （83.4%±7.3%））. All the patients were diagnosed as having blast injury and moderate or severe inhalation injury. Functions of the heart, liver, kidney, lung, pancreas and coagulation were observed. Autopsy samples of the heart, liver, and lungs were taken from the deceased. Comprehensive measures were taken during the treatment, including protection of organ dys function, use of antibiotics, early anticoagulant treatment, early closure of burn wounds, etc. All the data were analyzed statistically with t test.Results One patient died of septic shock 23 hours after admission （four days after injury）, the others survived. Dysfunction of the heart, liver, lungs, pancreas, and coagulation were found in all the patients on admission, and the functions were ameliorated after appropriate treatments.Conclusions Burn-blast combined injury may cause multiple organ dysfunctions, especially coagulopathy. Proper judgment of patients＇ condition, energetic anticoagulant treatment, early closure of burn wounds, rational use of antibiotics, nutritional support, intensive insulin treatment, timely and effective support and protection of organ function are the most important contributory factors in successful treatment of burn-blast combined injuries.

关键词： burn-blast combined injury treatment

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Role of speckle tracking imaging in the assessment of myocardial regional ventricular function in experimental blunt cardiac injury

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Chinese Journal of Traumatology 2015年第4期18卷 223-228页

作者： Wen-Hua Du Xiang Wang Xiu-Qin xiong Tao Li Hua-Ping Liang State Key Laboratory of Trauma Burns and Combined Injury Department of Ultrasound Daping Hospital and Research Institute of Surgery the Third Military Medical UniversityChongqing 40042 China State Key Laboratory of Trauma. bums. and Combined Injury Department 1 Daping Hospital and Research Institute of Surgery. the Third Military Medical University Chongqing 40042. China

Purpose： To evaluate the usefulness and information collecting ability of speckle tracking imaging techniques in the assessment of myocardial regional ventricular contractility in a rabbit model with blunt cardiac injury. Methods： Fifteen healthy New Zealand rabbits weighing （2.70 ± 0.28） kg were anesthetized （3% pentobarbital sodium/i.v） and impacted using the BIM-II biological impact machine to induce myocardial contusion （MC）. Hemodynamic parameters, such as heart rate, systolic pressure, mean arterial pressure, diastolic pressure and central venous pressure, were determined before and after MC. Further, param- eters reflecting left ventricular functions, such as left ventricular end systolic pressure, left ventricular end diastolic pressure, isovolumic pressure （IP） and the maximal increasing/decreasing rate of left intraventricular pressure （±dp/dtmax）, were also determined before and after MC. Left ventricular functions were determined either by two dimensional transthoracic echocardiography or by speckle tracking imaging for segmental abnormal ventricular wall motions. Results： Heart rate, systolic pressure, diastolic pressure and mean arterial pressure decreased signifi- cantly but transiently, while central venous pressure markedly increased after MC. In contrast to significant changes in diastolic functions, there was no significant change in cardiac systolic functions after MC. The speckle tracking imaging demonstrated that strain values of different myocardial segment significantly decreased post impact, and that of the ventricular segment decreased from segment to segment. Conclusion： Speckle tracking imaging is useful and informative to assess myocardial regional dysfunctions post MC.

关键词： Speckle tracking imaging Myocardial contusion Hemodynamics Echocardiography

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