Search

BACKGROUND A monitoring method is needed to further guide fluid resuscitation in severe burn injury. This study was performed to investigate the effects of pulse contour cardiac output (PCCO) monitoring on the prognosis of adult severe burns patients. METHODS We conducted a retrospective study enrolling patients from January 2015 to December 2020, who were divided into a control group receiving conventional monitoring and a study group receiving PCCO monitoring. The primary outcomes were 28-day mortality and total mortality, and the secondary outcomes included burn-related complications and the length of hospital stay and ICU stay. Multivariable logistic regression analysis and linear regression analysis were performed to determine the risk factors of burns-related complications and length of hospital stay in enrolled patients. RESULTS A total of 109 patients in the control group and 82 patients in the study group were enrolled. While the area of full thickness burn was much higher in the control group than in the study group (P=0.021), no significant difference was found in other characteristics between the two groups. During fluid resuscitation, the fluid volume ratio of the study group was significantly different from that of the control group, and both in the first 24 hours and the second 24 hours, the resuscitation fluid volume ratio and colloid volume ratio was significantly higher in the control group than in the study group (all P

The mechanism of action underlying the intriguing prominent bioactivity of urinary bladder matrix (UBM) for in situ tissue regeneration of soft tissue defects remains to be elucidated. It is speculated that the activity of UBM for cell adhesion, migration, and activation is inherent. The bioactivity of UBM for in situ tissue regeneration and its relation with the structure and intact soluble components of UBM were investigated in comparison to a collagen-based scaffold, PELNAC (PEL). We isolated the soluble component of the two materials with urea buffer, and evaluated the respective effect of these soluble components on the in vitro adhesion and migration of L929 fibroblasts. The spatiotemporal pattern of endogenous-cell ingrowth into the scaffolds and cell activation were investigated using a model of murine subcutaneous implantation. UBM is more capable of promoting the adhesion, migration, and proliferation of fibroblasts than PEL in a serum-independent manner. In vivo, as compared with PEL, UBM exhibits significantly enhanced activity for fast endogenous cell ingrowth and produces a more prominent pro-regenerative and pro-remodeling microenvironment by inducing the expression of TGF-β1, VEGF, MMP-9, and murine type I collagen. Overall, our results suggest the prominent bioactivity of UBM for in situ tissue regeneration is inherent.

92 cases of second degree burn wounds treated in our hospital from January 2019 to December 2019 were selected as the research objects, and the clinical effect of eCASH concept treatment combined with nano silver dressing on the second degree burn wounds was studied. The patients were randomly divided into control group (n = 46) and observation group (n = 46). The control group was treated with conventional treatment combined with eCASH concept nursing, and the observation group was treated with eCASH concept combined with nano silver dressing. We found that the effective rate of the observation group was 95.65% higher than that of the control group (76.09%); the wound healing time of the observation group was significantly lower than that of the control group; the average VAS pain score of the observation group during wound treatment was significantly lower than that of the control group The total positive rate of bacterial detection in the observation group was 8.70%, which was lower than 28.26% in the control group; the incidence of complications in the observation group was 2.17% lower than that in the control group (17.39%); the differences were statistically significant (all P < 0.05). These results indicate that eCASH concept combined with nano silver dressing in the treatment of second degree burn wounds has a significant effect, which can accelerate the recovery, reduce the pain, and effectively reduce the total positive rate of bacterial detection and the incidence of complications.

In recent years, as living standards have continued to improve, the number of diabetes patients in China, along with the incidence of complications associated with the disease, has been increasing. Among these complications, diabetic foot disease is one of the main causes of disability and death in diabetic patients. Due to the differences in economy, culture, religion and level of medical care available across different regions, preventive and treatment methods and curative results for diabetic foot vary greatly. In multidisciplinary models built around diabetic foot, the timely assessment and diagnosis of wounds and appropriate methods of prevention and treatment with internal and external surgery are key to clinical practice for this pathology. In 2019, under the leadership of the Jiangsu Medical Association and Chinese Diabetes Society, the writing group for the Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition) was established with the participation of scholars from the specialist areas of endocrinology, burn injury, vascular surgery, orthopedics, foot and ankle surgery and cardiology. Drawing lessons from diabetic foot guidelines from other countries, this guide analyses clinical practices for diabetic foot, queries the theoretical basis and grades and gives recommendations based on the characteristics of the pathology in China. This paper begins with assessments and diagnoses of diabetic foot, then describes treatments for diabetic foot in detail, and ends with protections for high-risk feet and the prevention of ulcers. This manuscript covers the disciplines of internal medicine, surgical, nursing and rehabilitation and describes a total of 50 recommendations that we hope will provide procedures and protocols for clinicians dealing with diabetic foot.Registry number: IPGRP-2020cn124

Postbuckling behavior of the 3D braided rectangular plates subjected to uniaxial compression combined with transverse loads in thermal environments is presented. Based on a micro-macro-mechanical model, a 3D braided composite may be treated as a cell system and the geometry of each cell is deeply dependent on its position in the cross-section of the plate. The material properties of the epoxy are expressed as a linear function of temperature. Uniform, linear and nonlinear temperature distributions through the thickness are involved. The lateral pressure (three types of transverse loads, i.e. transverse uniform load; transverse patch load over a central area; and transverse sinusoidal load) is first converted into an initial deflection and the initial geometric imperfection of the plate is taken into account. The governing equations are based on Reddy’s higher-order shear deformation plate theory with a von Karman-type of kinematic nonlinearity. Two cases of the in-plane boundary conditions are also taken into account. A perturbation technique is employed to determine buckling loads and postbuckling equilibrium paths of simply supported 3D braided rectangular plates. The results reveal that the temperature rise, geometric parameter, fiber volume fraction, braiding angle, the character of the in-plane boundary conditions and different types of initial transverse loads have a significant effect on the buckling and postbuckling behavior of the braided composite plates.

To investigate the therapeutic effect of V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery for skin defect at the same dorsal finger.Between January 2008 and February 2010, 15 cases of skin defect at the same dorsal finger were treated. There were 9 males and 6 females, aged 15-72 years (mean, 43 years). Defect was caused by saw machine in 6 cases, machines crush in 7 cases, and cutting nodule in 2 cases. The locations were distal dorsal finger in 2 cases, middle dorsal finger in 6 cases, and proximal dorsal finger in 7 cases. All cases complicated by exposure of tendon and bone. The size of defect ranged from 0.8 cm x 0.5 cm to 1.4 cm x 1.0 cm. The interval between injury and operation was 3-8 hours. All fingers were treated by V-Y advancement flap from the dorsal cutaneous branch of digital artery, which size was 1.2 cm x 0.8 cm-2.5 cm x 1.0 cm, and the donor site was directly sutured. Fracture reduction and Kirschner wire for internal fixation were performed in the patients with fracture; extensor tendon was repaired with 4-0 thread in the patients with tendon injury.All flaps survived completely. The incisions of donor and recipient sites healed by first intention. Ten cases were followed up 6 months to 2 years after operation. The flaps had good texture, color, and appearance; 2-point discrimination of the V-Y flap was 10-12 mm. X-ray examination showed that all finger fractures healed successfully in 5 cases, with an average bone union time of 6 weeks (range, 5-8 weeks). According to the criteria for function assessment by total active motion, the results were excellent in 8 cases, good in 1, and fair in 1 with an excellent and good rate of 90%.It is an ideal method to treat skin defect at the same dorsal finger with V-Y advancement flap pedicled with dorsal cutaneous branch of digital artery.