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Epidemiological and clinical characteristics of burns in the older person:a seven-year retrospective analysis of 693 cases at a burn center in south-west China

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burns & Trauma 2020年第1期8卷 368-379页

作者： Wei Qian Song Wang Yangping Wang Xiaorong Zhang Mian Liu Rixing Zhan Yong Huang Weifeng He Gaoxing Luo Institute of burn Research State Key Laboratory of TraumaBurn and Combined InjuryKey Laboratory of Disease Proteomics of ChongqingSouthwest HospitalThird Military Medical University(Army Medical University)Chongqing 400038China

Background:burns are one of the major traumas that may affect older *** purpose of this study was to investigate the epidemiological and clinical characteristics of geriatric burns at a major center in south-west ***:This retrospective study was conducted at the Institute of burn Research,Southwest Hospital of Army Medical University between 2010 and 2016,and the data collected from medical records included admission date,age,gender,premorbid disease,burn etiology,injured anatomical location,burn area and depth,inhalation injury,number of surgeries,length of stay(LOS),clinical outcome,and medical ***:Of the 693 older burn patients included,60.75%were male and 56.85%were aged 60–69 *** peaked in December–March and *** the most common cause of burns,making up 51.95%of all cases,and also dominated in the burn patients aged 60–69 *** were the most common anatomical sites of burns(69.41%),and the median total body surface area(TBSA)was 5%(interquartile range[IQR]:2%–15%).The percentage of the patients who underwent surgeries and number of surgeries significantly increased in the cases of contact burns,younger age and full-thickness *** deaths resulted in a mortality of 0.9%.The median LOSwas 16 days(IQR:8–29 days),and the main risk factors were more surgeries,better outcomes,and full-thickness *** median costwas 20,228 CNY(IQR:10,457–46,581.5 CNY),and major risk factors included longer LOS,larger TBSA,and more ***,compared to the earlier data from our center,the proportion of older adults among all burns(7.50%vs.4.15%),proportion of flame burns(51.95%vs.33.90%),and mean age(69.05 years vs.65.10 years)were significantly higher,while the proportion of premorbidities(16.9%vs.83.9%),mortality(0.9%vs.7.5%)and median TBSA(5%vs.21%)were significantly ***:This study suggested that closer attention should be paid to prevent burn injuries in older people aged 60–69 years,especially

关键词： Geriatric burns Epidemiology Outcome Cost Risk factors

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Characteristics of burn deaths from 2003 to 2009 in a burn center: A retrospective study

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burns & Trauma 2013年第2期1卷 80-86页

作者： Jian Chen Hong Yan Gaoxing Luo Qizhi Luo Xiaolu Li Jiaping Zhang Zhiqiang Yuan Daizhi Peng Yizhi Peng Jianian Hu Jun Wu Institute of burn Research Southwest Hospital State Key Laboratory of Trauma Burns and Combined Injury The Third Military Medical University Chongqing China

Mortality remains one of the most important end-point quality control parameters to evaluate a burn care system. We retrospectively reviewed the characteristics and multiple organ dysfunction syndrome (MODS) patterns of burn deaths in our center from January 2003 to December 2009. The mortality rate during this time period was 2.3%. Fifty-six patients died, including 49 males and 7 females. The mean survival time was 28.45 ± 24.60 days. The burn percentage was (76.70 ± 26.86) % total burn surface area (TBSA), with (27.74 ± 24.95) % deep-partial thickness burns and (46.88 ± 33.84) % full-thickness burns. Inhalation injury was diagnosed in 36 (64.29%) patients. Patients who had undergone an operation, particularly in the first week post-burn, had a significantly longer survival time. An average of 5.50 ± 1.35 malfunctioning organs per patient and a mean sequential organ failure assessment (SOFA) score of 13.91 ± 3.65 were observed. The most frequently malfunctioning organs were involved in the respiratory, hematologic, circulatory, and central nervous systems. Most of the organ damage occurred during the first week post-burn, followed by 4 weeks later, with relatively less organ damage observed in the third week. Among patients with a TBSA over 50%, non-survivors had larger burn sizes (particularly larger full-thickness burns) and a higher incidence of inhalation injury compared with survivors;nonsurvivors were also more likely to have microorganism-positive blood and sputum cultures. In conclusion, burn deaths are related to a higher burn percentage, inhalation injury, MODS, and infection. Early operation may help improve survival duration.

关键词： burns death multiple organ dysfunction syndrome

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Construction of the tissue engineering seed cells(HaCaT-EGF) and analysis of its biological characteristics

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Asian Pacific Journal of Tropical Medicine 2013年第11期6卷 893-896页

作者： Ke Tao Xiao-Zhi Bai Zhan-Feng Zhang Ji-Hong Shi Xiao-Qiang Li Chao-Wu Tang Da-Hai Hu Jun-Tao Han burn center of PLA Xijing Hospitalthe Fourth Military Medical University

Objective:To construct the tissue engineering seed cell(HaCaT cell line) with stable expression of the human epidermal growth factor(EGF),and analyze the changes of its biological ***:PCDNA3.1-EGF eukaryotic expression vector was transferred into HaCaT cell,and G418 was utilized to select the HaCaT-EGF cell *** an inverted microscope,PCR,ELISA method to detect the changes of the cell morphology,the expression of the ECF gene and protein,and the mRNA expression levels of apoptosis related molecule Caspase-3,the cell cycle related protein cyclin ***:The mRNA expression levels of the obtained HaCaT-ECF cell were more than 100 times higher than the level of ordinary HaCaT *** colony of the HaCaT-EGF cells was more focused and tight compared to the empty vector transfected HaCaT cells and normal HaCaT *** expression levels of apoptotic factor Caspase-3 and cyclin Dt in HaCaT-EGF cell were significantly higher than those in the empty vector HaCaT- pcDNA3.1 cell,and the differences were statistically significant(P0.05).Conclusions: HaCaT-EGF cell can continuously secrete ECF,and the biological characteristic is *** can be used for tissue engineering experiment and is an ideal seed cell for constructing tissue engineered skin.

关键词： Tissue engineering HaCaT Gene transfection Biological characteristics

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Causes of immune dysfunction in hyperbilirubinemia model rats

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Asian Pacific Journal of Tropical Medicine 2015年第5期8卷 382-385页

作者： Xiao-Min Sun Ping Kang Ke Tao Department of General Internal Medicine Children's Hospital of Zhengzhou burn center of PLA Xijing Hospitalthe Fourth Military Medical University

Objective:To explore the causes of immune dysfunction in neonatal rats with ***:A total of 60 newborn SD rats were equally randomized into normal saline(NS) group,LPS control group,bilirubin control group,low-dose group and high-dose *** anesthesia,0.1 mL NS was given to the NS and LPS control group and different doses of bilirubin for the other groups;1 h later,the NS and bilirubin control group received the intraperitoneal injection of 0.05 mL NS and 1mg/kg LPS for the other *** 5 or 24 hours of model establishment,spleens were collected for detecting the expression levels of MyD88 and p-TAK1 protein and the spleen cells apoptosis by immunohistochemmistry and TUNEL *** 24 hours of model establishment,scrum inflammatory factors levels and T cell subsets distribution were determined by ELISA and flow ***:In contrast to low-dose bilirubin,high-dose bilirubin could induce spleen cells apoptosis in coordination with *** 5 hours of model establishment,compared with NS ***88 expression level in low-dose group elevated while p-TAK1 level in high-dose group reduced(P<0.05).In high-dose group,inflammotory factors levels and CD8^+T cells percentage were all higher than LPS control and NS group(P<0.05),while CD4^+ T cells percentage was lower than NS group(P<0.05).Conclusions:High-concentration plasma bilirubin in coordination with LPS could inhibit NF- κB signal pathways activation and aggravate inflammatory reaction,thus caused immunosuppression with inflammation cascade,which resulted in the immune dysfunction.

关键词： Bilirubin Myd88 p-p38MAPK Spleen cells Hyperbilirubinemia

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Enzymatic debridement shall not modify the global strategy for mass burn events

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military Medical Research 2023年第4期10卷 554-555页

作者： Nicolas Donat Thomas Leclerc Stian Kreken Almeland burn Treatment Centre Percy Military Teaching Hospital92140 ClamartFrance Val-de-Grâce military Medical Academy 75005 ParisFrance Norwegian National burn center Department of PlasticHand and Reconstructive SurgeryHaukeland University Hospital5021 BergenNorway

We read with interest the letter by Surowiecka et al.[1]about early burn wound excision in mass casualty *** couldn’t agree more with their statement about the benefit of early burn wound ***,we doubt whether applying this strategy to every patient during a mass burn event could be *** note,while there is an undisputed consensus that early burn wound excision is the gold standard of burn care,what‘early’actually means is still *** on the authors,the corresponding time limit typically varies from 24 h to a few days[2,3].

关键词： Enzymatic debridement(ED) burn care Mass causality burn surgery

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Silk-based nerve guidance conduits with macroscopic holes modulate the vascularization of regenerating rat sciatic nerve

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Neural Regeneration Research 2025年第6期20卷 1789-1800页

作者： Carina Hromada Patrick Heimel Markus Kerbl LászlóGál Sylvia Nürnberger Barbara Schaedl James Ferguson Nicole Swiadek Xavier Monforte Johannes C.Heinzel Antal Nógrádi Andreas H.Teuschl-Woller David Hercher Department Life Science Engineering University of Applied Sciences Technikum WienViennaAustria Austrian Cluster for Tissue Regeneration ViennaAustria Ludwig Boltzmann Institute for Traumatology The Research Center in Cooperation with AUVAViennaAustria University Clinic of Dentistry Medical University of ViennaViennaAustria Department of Plastic Reconstructive and Aesthetic SurgeryLandesklinikum Wiener Neustadt2700 Wiener NeustadtAustria Department of Anatomy Histology and EmbryologyAlbert Szent-Györgyi Medical SchoolUniversity of SzegedSzegedHungary Medical University of Vienna Department of Orthopedics and Trauma SurgeryDevision of Trauma SurgeryViennaAustria Department of Hand- PlasticReconstructive and Burn SurgeryBG Unfallklinik TuebingenUniversity of TuebingenTuebingenGermany

Peripheral nerve injuries induce a severe motor and sensory deficit. Since the availability of autologous nerve transplants for nerve repair is very limited, alternative treatment strategies are sought, including the use of tubular nerve guidance conduits(tNGCs). However, the use of tNGCs results in poor functional recovery and central necrosis of the regenerating tissue, which limits their application to short nerve lesion defects(typically shorter than 3 cm). Given the importance of vascularization in nerve regeneration, we hypothesized that enabling the growth of blood vessels from the surrounding tissue into the regenerating nerve within the tNGC would help eliminate necrotic processes and lead to improved regeneration. In this study, we reported the application of macroscopic holes into the tubular walls of silk-based tNGCs and compared the various features of these improved silk^(+) tNGCs with the tubes without holes(silk^(–) tNGCs) and autologous nerve transplants in an 8-mm sciatic nerve defect in rats. Using a combination of micro-computed tomography and histological analyses, we were able to prove that the use of silk^(+) tNGCs induced the growth of blood vessels from the adjacent tissue to the intraluminal neovascular formation. A significantly higher number of blood vessels in the silk^(+) group was found compared with autologous nerve transplants and silk^(–), accompanied by improved axon regeneration at the distal coaptation point compared with the silk^(–) tNGCs at 7 weeks postoperatively. In the 15-mm(critical size) sciatic nerve defect model, we again observed a distinct ingrowth of blood vessels through the tubular walls of silk^(+) tNGCs, but without improved functional recovery at 12 weeks postoperatively. Our data proves that macroporous tNGCs increase the vascular supply of regenerating nerves and facilitate improved axonal regeneration in a short-defect model but not in a critical-size defect model. This study suggests that further optimizatio

关键词： axon regeneration blood vessel functional recovery macroporous nerve lesion peripheral nerve repair sciatic nerve silk-based nerve guidance conduit vascularization

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Comparison of short- with long-term regeneration results after digital nerve reconstruction with musclein-vein conduits

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Neural Regeneration Research 2015年第10期10卷 1674-1677页

作者： Jennifer Lynn Schiefer Lukas Schulz Rebekka Rath Stéphane Stahl Hans-Eberhard Schaller Theodora Manoli Department of Hand Plastic and Reconstructive Surgery with Burn Center BG Trauma Center University of Tuebingen

Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits. Static and moving two-point discriminations and Semmes-Weinstein Monofilaments were used to evaluate sensory recovery 6–12 months and 14–35 months after repair of digital nerves with muscle-in-vein in 7 cases. Both follow-ups were performed after clinical signs of progressing regeneration disappeared. In 4 of 7 cases, a further recovery of both two-point discriminations and in another case of only the static two-point discrimination of 1–3 mm could be found between the short-term and long-term follow-up examination. Moreover, a late recovery of both two-point discriminations was demonstrated in another case. Four of 7 cases showed a sensory improvement by one Semmes-Weinstein Monofilaments. This pilot study suggests that sensory recovery still takes place even when clinical signs of progressing regeneration disappear.

关键词： peripheral nerve regeneration muscle-in-vein conduits digital nerves sensory recovery Semmes-Weinstein two-point discrimination outcome short-term long-term

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Pharmacological treatment of inhalation injury after nuclear or radiological incidents: The Chinese and German approach

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military Medical Research 2019年第2期6卷 159-169页

作者： Tian-Tian Yan Guo-An Lin Min-Jie Wang Andreas Lamkowski Matthias Port Alexis Rump military burn center the990th Hospital of the Joint Logistics SupportForces of Chinese PLA(the159th Hospital of Chinese PLA)Zhumadian463000HenanChina Bundeswehr Institute of Radiobiology MunichGermany

Inhalation injury is often associated with burns and significantly increases morbidity and mortality. The main toxic components of fire smoke are carbon monoxide, hydrogen cyanide, and irritants. In the case of an incident at a nuclear power plant or recycling facility associated with fire, smoke may also contain radioactive material. Medical treatments may vary in different countries, and in this paper, we discuss the similarities and differences in the treatments between China and Germany. Carbon monoxide poisoning is treated by 100% oxygen administration and,if available, hyperbaric oxygenation in China as well as in Germany. In addition, antidotes binding the cyanide ions and relieving the respiratory chain are important. Methemoglobin-forming agents(e.g., nitrites, dimethylaminophenol)or hydroxocobalamin(Vitamin B12) are options. The metabolic elimination of cyanide may be enhanced by sodium thiosulfate. In China, sodium nitrite with sodium thiosulfate is the most common combination. The use of dimethylaminophenol instead of sodium nitrite is typical for Germany, and hydroxocobalamin is considered the antidote of choice if available in cases of cyanide intoxications by fire smoke inhalation as it does not further reduce oxygen transport capacity. Systematic prophylactic use of corticosteroids to prevent toxic pulmonary edema is not recommended in China or Germany. Stable iodine is indicated in the case of radioiodine exposure and must be administered within several hours to be effective. The decorporation of metal radionuclides is possible with Ca(DTPA)or Prussian blue that should be given as soon as possible. These medications are used in both countries, but it seems that Ca(DTPA) is administered at lower dosages in China. Although the details of the treatment of inhalation injury and radionuclide(s) decorporation may vary, the general therapeutic strategy is very similar in China and Germany.

关键词： Fire smoke Inhalation injury Carbon monoxide Cyanide Radionuclide incorporation Decorporation

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Influence of immobilization and sensory re-education on the sensory recovery after reconstruction of digital nerves with direct suture or muscle-in-vein conduits

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Neural Regeneration Research 2016年第2期11卷 338-344页

作者： Theodora Manoli Jennifer Lynn Schiefer Lukas Schulz Thomas Fuchsberger Hans-Eberhard Schaller Department of Hand Plastic and Reconstructive Surgery Burn Unit BG Trauma Center University of Tuebingen

The influence of duration of immobilization and postoperative sensory re-education on the final outcome after reconstruction of digital nerves with direct suture or muscle-in-vein conduits was investigated. The final sensory outcome of 35 patients with 41 digital nerve injuries, who either underwent a direct suture（DS） or a nerve reconstruction with muscle-in-vein conduits（MVC）, was assessed the earliest 12 months postoperatively using static and moving two-point discrimination as well as Semmes-Weinstein monofilaments. There was no significant difference in sensory recovery in cases with an immobilization of 3–7 days versus 10 days in the DS or MVC group. Moreover, no statistically significant difference in sensory recovery was found in cases receiving postoperative sensory re-education versus those not receiving in the DS or MVC group. An early mobilization does not seem to have a negative impact on the final outcome after digital nerve reconstruction. The effect of sensory re-education after digital nerve reconstruction should be reconsidered.

关键词： nerve regeneration peripheral nerve digital nerve sensory re-education immobilization digital direct suture muscle-in-vein conduits

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Construction of millimeter-scale vascularized engineered myocardial tissue using a mixed gel

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Regenerative Biomaterials 2024年第3期3卷 56-67页

作者： Ming Ke Wenhui Xu Yansha Hao Feiyang Zheng Guanyuan Yang Yonghong Fan Fangfang Wang Zhiqiang Nie Chuhong Zhu Department of Anatomy Third Military Medical UniversityChongqing 400038China State Key Laboratory of Trauma Burn and Combined InjuryChongqing 400038China Department of Plastic and Aesthetic Surgery Southwest HospitalThird Military Medical UniversityChongqing 400038China Engineering Research center of Tissue and Organ Regeneration and Manufacturing Ministry of EducationChongqing 400038China

Engineering myocardium has shown great clinal potential for repairing permanent myocardial ***,the lack of perfusing blood vessels and difficulties in preparing a thick-engineered myocardium result in its limited clinical *** prepared a mixed gel containing fibrin(5 mg/ml)and collagen I(0.2 mg/ml)and verified that human umbilical vein endothelial cells(HUVECs)and human-induced pluripotent stem cell-derived cardiomyocytes(hiPSC-CMs)could fom microvascular lumens and myocardial cell clusters by harnessing the low-hardness and hyperelastic characteristics of ***-CMs and HUVECs in the mixed gel formed self-organized cell clusters,which were then cultured in different media using a three-phase *** successfully constructed vascularized engineered myocardial tissue had a spherical structure and final diameter of *** tissue exhibited autonomous beats that occured at a frequency similar to a normal human heart *** internal microvascular lumen could be maintained for 6 weeks and showed good results during preliminary surface re-vascularization in vitro and vascular remodeling in *** summary,we propose a simple method for constructing vascularized engineered myocardial tissue,through phased cultivation that does not rely on high-end manufacturing equipment and cutting-edge preparation *** constructed tissue has potential value for clinical use after preliminary evaluation.

关键词： engineered myocardium vascularized hiPSC-CM HUVEC fibrin

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