| Metabolism is the basic character of life. Burn and other severe injuries are associated with pronounced metabolic changes in most organs and tissues. The abnormity of energy metabolism could affect the normal function of organs and tissues. As our general understanding has advanced in leaps and bounds in various areas of biomedical research over the past decades, we have been able to look deeper and deeper into the phenomenon of thermal insult, in which the important pathophysiological consequences of burn injury is related to toxins released from bura devitalized skin which may be one of principal causes of systemic inflammatory response. The metabolic response to bum is characterized by protein and lipid catabolism, total body protein loss, peripheral insulin resistance, and increased energy expenditure. However, the fundamenta! studies on the field of operation adjust are rarely reported in domestic and foreign literatures. The present study was performed to evaluate the effects of escharectomy during burn shock stage on energy metabolism.In the first part of this study, a series of experimentalstudies related to energy metabolism and operation were carried on. One hundred and twelve male Wistar rats were subjected to a 30% total body surface area full-thickness thermal injury. The rats were randomly divided into two groups: escharectomy during burn shock stage group (group A) and escharectomy after bura shock stage group(group B). The contents of adenosine triphosphate (ATP) and the activities and quantities of ATPase. in the heart, liver and skeletal muscle and the levels of LPS, TNF- a in plasma were sequentially determined and analyzed at different time point. Results:1. The results showed that the contents of ATP in the heart, liver and skeletal muscle decreased rapidly post burn. The contents of ATP in group A were higher than group B obviously (P<0.01) .2. The images scanned under microscope were analyzed by image analysis system, the results showed the activities and quantities of ATPase in the heart, liver and skeletal muscle decreased at the same time post bum, but they were higher in group A at the end of experiment than group B.3. Significant negative correlations between the contents of ATP in viscera and levels of LPS, TNF- a in plasma were noted.4. The damage of mitochondrial structure of heart, liver and skeletal muscle was observed by electron microscope post bum. The decrease of mitochondrialcrystal membrane density of burned rats was tightly related to dysfunctipn of mitochondrial respiration and energy synthesis. But the mitochondrial structure were rebuilt rapidly in the rats who accepted escharectomy during burn shock stage.Our before-mentioned research indicated that energy disturbance appears in cellular metabolism post burn, which includes not only energy supply but also energy application, and escharectomy during burn shock stage could relieve hypermetabolism after extensive burn to some degree. But little research related to the changes of irritability of nerve-incretion system post escharectomy during burn shock stage has been carried out. Thus the main purpose of the second part of this study is to find out the influence of escharectomy during burn shock stage on irritability and to determine the changes of resting energy expenditure (REE) in normal and post burn stage, and the effect of escharectomy during burn shock stage on energy expenditure.In the second part of this study, 30% TBSA HI degree burn swine model was used. Sixteen male minipigs were randomly divided into two groups: escharectomy during burn shock stage group (group A) and escharectomy after burn shock stage group (group B). REEs were monitored by means of Metabolic cart (Medical Graphics Corporation, USA). The sequential changes in plasma levels of insulin, glucagon, cortisol, growth hormone (GH) and Insulin-like growth factor (IGF-1) were analyzed.Results:1. The levels of REE increased immediately post burn. REE decreased early in g...
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