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高迁移率族蛋白B1在创伤免疫功能紊乱中的作用及其调节机制
Objective To investigate the potential effect of high mobility group box 1 protein (HMGB1) on host immune response and its molecular regulation mechanism as well as its interventional pathway following major burns/trauma. Methods With both animal experiments and clinical investigation, serial studies were conducted to observe the effects of HMGB1 on changes in immune function of T lymphoeytes, dendritic cells, and macrophages both in vivo and in vitro. Results It was found that thermal injury or trauma induced a delayed and persistent increase in HMGB1 expression as well as its release in various tissues.HMGB1 formation could markedly influence the cell-mediated immunity, including the changes in T lymphocytes, dendritic cells, and macrophages following major trauma or burns. These effects were closely related with dysfunction of various organs in the course of sepsis. Conclusion These data proved that HMGB1 not only acts as a novel "late" inflammatory mediator but is also closely associated with immunosuppression after acute insults. HMGB1 might play an important role in inducing systemic inflammatory response together with host immunological dissonance, resulting in the development of septic complications. Intervention of HMGB1 expression and release presumably provides a potentially effective way to regulate both excessive inflammatory and immune response, thereby as a measure to improve the prognosis of severe sepsis secondary to major trauma.
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严重烧伤患者的早期肠道营养与康复
Objective To explore the effect of rehabilitation through analysis the early enteral feeding on the prevention of enteral infection in severely burned patients .Method A total of 22 patients with severe burns were randomly divided into an early enteral feeding group (EF) and a delayed enteral feeding group (DF). The levels of serum endotoxin were detected in the members of both groups in 1, 3, and 5 days .Result The levels of serum endotoxin in severely burned patients were significantly higher than in normal subjects (P< 0.01) . The levels of serum endotoxin in the EF group were significantly lower than in the DF group (P< 0.01). Conclusion Early enteral feeding may decrease enterogenic infection and it helps the nutrition support, improve the patient resistance, facilitate the repair of damaged tissue , so it contributes to the rehabilitation of burned patients.
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要素营养制剂ELENTAL对烧伤患者营养状况的维护效应
AIM:To investigate the maitainance effect of enteral feeding ELENTAL on intestine,liver and nutritional status of burned patients.METHODS:30 cases of burned patients were randomly devided into ELENTAL feeding group(E group) and intravenous nutrition group(control, D).The whole calorie in group E were supplied by feeding elemental diet ELENTAL and those in group D were supplied by intravenous nutrition from the third day after burning.the supplemented calorie and nitrogen were equal in two groups. Before the experiment and on the 5th day and 10th day,blood were drawn to examine the levels of and serum transferring.RESULTS:There were no significant difference of serum lipid and serum transferring levels on the 7th day and 10th day in burned patients.CONCLUSION:ELENTAL diet can protect intestine effectively and improve nutritious status of the burned patients.
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特大面积烧伤后期关节挛缩畸型部位功能整形后疗效分析
To discuss the effect of application of de cell xenoma dermal and chin auto- pachyderma in functional position anaplasty during the late period of super- large burn.Method To incise eschar and cograft of de- cell xenoma dermal and chin auto pachyderma on 15 arthrogryposis and deformation positions of 4 super- large burns and follow up for the effect regularly.Result 7 skin grafts were living entirely, 5 parts were healing in the short time by dressing change, 3 parts were healing by complement skingrafting,the mean survival rate of cograft was (94.9± 5.5)％ .Conclusion The local appearance was smooth and well- arranged,the character was soft and the function was well.The effect was near to large- leaf auto intermediate split thickness skin graft and can reach the purpose of functional restoration.
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严重烧伤后早期大鼠肾脏细胞粘附分子1和白介素6的表达与肾功能损害的相关性研究
Objective To clarify the mechanism and provide the basis for prevention and treatment of the early injuries of kidney after severe burn in rats.We observed the expression of intercellular adhesion molecule 1 and interleukin 6 and the early pathological changes in different time.Method Early pathological changes in the kidney were observed by LM and EM.The expression of ICAM 1 were observed by immunohistochemistry,in situ hybridization.The expression of IL 6 was also observed.Result From 5 min to 72 h after burn,the early changes in the kidney included edema,hemorrhage, and congestion,injury of capillary epithelium cells.2ICAM 1 and IL 6 were higher in the kidney 30 min after burn,and from 2 h to 24 h,they were strongest positive,but on 72 h,they were negative.Conclusion ICAM-1 and IL 6 may play important roles in mechanisms of kidney injury,and the major target cells may be the endothelium cells.
关键词： endothelium cell kidney ICAM-1 burn
