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Background and purpose since the 1980s, our group through a series of studies, and certainly severe burns early myocardial damage, activation of the heart itself RAS system initiating factor is the importance of early myocardial ischemia and hypoxia. Cardiac cycle power organ, severe burns soon as early (prior to lead to a significant reduction in the effective circulating blood volume due to increased capillary permeability) myocardial damage and weakened heart function, not only caused cardiac dysfunction, but also induced or exacerbated by the shock, burns's important to start early ischemia and hypoxia factors. Based on this understanding, the \Therefore, to carry out an extremely important theoretical and clinical significance of myocardial damage after burn prevention research. The purpose of this project is to observed Shengmai injection mechanism and explore its role in prevention and treatment of postburn \Materials and methods. Prospective clinical study to develop inclusion and exclusion criteria selected our department from January 2005 to October, a total of 20 cases of patients with severe burns, according to the standard, complete randomization of the order of admission, a set of processing routine clinical treatment, do not use Shengmai injection control group (n = 10); another group on the basis of the clinical routine processing, give Shengmai injection treatment group (n = 10). Were 12,24,48 h after burn phase 3,4,5 d point venous blood samples sent to laboratory detection of serum cTnI, CK-MB and LDH, collecting data for statistical processing. Animal studies (1) Change of myocardial function: Healthy SD rats 54, body weight (210 ± 20) g, male or female, were randomly divided into three groups: normal group (N group, n = 6), not treated, normal left ventricular myocardial function was observed; simple scald group (B, n = 24), 30% TBSA Ⅲ degree burns (biopsy confirmed) prepared by conventional methods, scalded Parkland formula (four ml · kg of -1 1% TBSA -1 24 h -1 ) intraperitoneal injection of Ringer's lactate liquid recovery; Shengmai injection treatment group (S group, n = 24), model preparation with group B after burn instantly give 4 ml · Kg -1 Shengmai injection by intraperitoneal injection. Maximum rate multichannel physiologic monitoring logger detection of left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP) and left ventricular isovolumic contraction Center indoor pressure rise / fall (± dp / dt max) and other indicators. (2) prevention and control mechanism of the \Burns and burns after 1, 3, 6, 12 and 24 hours, 6 time points were sacrificed rats collected abdominal aortic blood. Anticoagulation after separation of the plasma stored at -20 ℃ under test. Sterile specimens from myocardial tissue in liquid nitrogen cryopreservation for inspection. Myocardial tissue sections under light microscope to observe the pathological changes of myocardial tissue; the thiobarbituric acid Law colorimetric detection of myocardial tissue homogenate MDA, caspase-3 activity by fluorescence assay of the myocardial tissue, cardiomyocyte apoptosis was detected by TUNEL method . Results of a prospective clinical study results) serum cTnI assay results burn 12h, the control group (n = 10) and treatment group (n = 10) patients cTnI reached the highest value, its mean than normal (I unit normal reference value of 0.00 ~ 0.04μg / L) limits were 14.6 times and 6.8 times higher (P (0.01). subsequently showed a gradual downward trend, close to the normal range in the five days after the injury for 12 h after injury, 24 h, 48 h, treatment group cTnI was significantly lower than the control group (P <0.05). 2) serum CK-MB and LDH test results 12 hours after burn, the two groups of patients in serum CK-MB (LDH) respectively in each group the highest value, the mean than normal [our hospital normal human serum CK-MB (LDH) reference range for 0 ~ 25 IU / L (1.9 ~ 4.0μol · s -1 · L -1 )] limits were higher than 2.1 (1.5) times and 3.6 (2.1) times (P <0.01). Downward trend thereafter, in four or five days after injury to the normal range. Burns after the first three days of treatment group were significantly lower than the control group (P <0.05). Experimental study of the changes in myocardial mechanics within 12 hours after injury, the control group, left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), left ventricular pressure rise (decline) rate (± dp / dt max decline) and other the myocardial mechanics indicators showed increased 24 hours after injury, but still below the normal level. The medication group mechanical index were significantly improved (P <0.01), myocardial pathomorphological change mitigation that Shengmai injection has significantly improved the role of severely burned rat cardiac mechanics and reduce myocardial damage. \more clear and complete. Two groups of rats burns before (normal group) and no myocardial apoptosis positive cells can be detected 3 h after injury to the small amount of apoptotic cardiomyocytes, 6,12 h after injury significantly increased the number of apoptotic cells was still evident up to 24 h . 3,6,12,24 h, after injury, the treatment group compared with the control group the number of positive cells have reduced ,6-24 h significantly reduced. 6,12,24 h, after injury, the two groups apoptosis index was a significant difference (P <0.01). (2) the activity of caspase-3: two sets of caspase-3 activity in 3,6 h after injury, reached the peak; 3,6,12 h after injury, the treatment group compared with the control group of left ventricular myocardial tissue caspase-3 activity significantly reduce (P < 0.05). (3) MDA content: scald ago comparison, the control group, MDA three hours after the burn began to increase (p <0.05), and reached the peak at 6h, 12h and continued high 24h began to decline, but still significantly higher than the pre-injury (p <0.05). Hours after burn, 6h, medication MDA content before injury showed no significant difference (p> 0.05), 12h and 24h were significantly higher than before scalding level (p <0.05, p <0.01), but significantly lower than the level of the control group ( p <0.01). Discussion and conclusion, prospective study of clinical and animal experiments show that severely burned early myocardial pathological damage of varying degrees, demonstrated in the serum of cTnI, CK-MB, LDH indicators significantly increased myocardial mechanics all indicators significantly reduced. Shengmai injection can significantly reduce myocardial damage after burns, improvement of cTnI and CK-MB, LDH and myocardial mechanics of the indicators, the \For the the early postburn \2, according to the results of this study, Shengmai injection of burns after myocardial protection mechanism may by reducing severe burns early myocardial tissue caspase-3 activity, reduce myocardial apoptosis played prevention \role. Shengmai injection can effectively reduce the myocardial tissue content of MDA, played the role of anti-myocardial tissue peroxidation injury. This may play another mechanism to protect the myocardium Shengmai injection. Shengmai stable injection efficacy, clinical safety, found no obvious side effects and adverse reactions, comprehensive prevention and control postburn \fluid in burn shock heart \
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