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Zhou R, Tu Z, Chen D, Wang W, Liu S, She L, Li Z, Liu J, Li Y, Cui Y, Pan P, Xie F. Quantitative proteome and lysine succinylome characterization of zinc chloride smoke-induced lung injury in mice. Heliyon 2024; 10:e27450. [PMID: 38524532 PMCID: PMC10957386 DOI: 10.1016/j.heliyon.2024.e27450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/17/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
The inhalation of zinc chloride (ZnCl2) smoke is one of common resources of lung injury, potentially resulting in severe pulmonary complications and even mortality. The influence of ZnCl2 smoke on lysine succinylation (Ksucc) in the lungs remains uncertain. In this study, we used a ZnCl2 smoke inhalation mouse model to perform global proteomic and lysine succinylome analyses. A total of 6781 Ksucc sites were identified in the lungs, with injured lungs demonstrating a reduction to approximately 2000 Ksucc sites, and 91 proteins exhibiting at least five differences in the number of Ksucc sites. Quantitative analysis revealed variations in expression of 384 proteins and 749 Ksucc sites. The analysis of protein-protein interactions was conducted for proteins displaying differential expression and differentially expressed lysine succinylation. Notably, proteins with altered Ksucc exhibited increased connectivity compared with that in differentially expressed proteins. Beyond metabolic pathways, these highly connected proteins were also involved in lung injury-associated pathological reactions, including processes such as focal adhesion, adherens junction, and complement and coagulation cascades. Collectively, our findings contribute to the understanding of the molecular mechanisms underlaying ZnCl2 smoke-induced lung injury with a specific emphasis on lysine succinylation. These findings could pave the way for targeted interventions and therapeutic strategies to mitigate severe pulmonary complications and mortality associated with such injuries in humans.
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Affiliation(s)
- Rui Zhou
- The First Affiliated Hospital of Henan University of Chinese Medicine, 450000, Zhengzhou, Henan, China
| | - Zhiwei Tu
- National Center for Protein Sciences (Beijing), Institute of Lifeomics, 102206, Beijing, China
| | - Daishi Chen
- Department of Otorhinolaryngology, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, 515100, Shenzhen, Guangdong, China
| | - Wanmei Wang
- Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, 100850, Beijing, China
| | - Shuzi Liu
- College of Pulmonary and Critical Care Medicine, The First Medical Center of Chinese PLA General Hospital, 100048, Beijing, China
| | - Linjun She
- The First Affiliated Hospital of Henan University of Chinese Medicine, 450000, Zhengzhou, Henan, China
| | - Zhan Li
- The First Affiliated Hospital of Henan University of Chinese Medicine, 450000, Zhengzhou, Henan, China
| | - Jihong Liu
- The First Affiliated Hospital of Henan University of Chinese Medicine, 450000, Zhengzhou, Henan, China
| | - Yabin Li
- College of Pulmonary and Critical Care Medicine, The First Medical Center of Chinese PLA General Hospital, 100048, Beijing, China
| | - Yu Cui
- National Center for Protein Sciences (Beijing), Institute of Lifeomics, 102206, Beijing, China
- State Key Laboratory of Proteomics, 102206, Beijing, China
| | - Pan Pan
- College of Pulmonary and Critical Care Medicine, The First Medical Center of Chinese PLA General Hospital, 100048, Beijing, China
| | - Fei Xie
- College of Pulmonary and Critical Care Medicine, The First Medical Center of Chinese PLA General Hospital, 100048, Beijing, China
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Zamai L. Hypothesis: Efficacy of early treatments with some NSAIDs in COVID-19: Might it also depend on their direct and/or indirect zinc chelating ability? Br J Pharmacol 2023; 180:279-286. [PMID: 36482040 PMCID: PMC9877557 DOI: 10.1111/bph.15989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
The present work argues for the involvement of the zinc chelating ability of some non-steroidal anti-inflammatory drugs as an additive mechanism able to increase their efficacy against COVID-19.
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Affiliation(s)
- Loris Zamai
- Department of Biomolecular SciencesUniversity of Urbino Carlo BoUrbinoItaly,National Institute for Nuclear Physics (INFN)—Gran Sasso National Laboratory (LNGS)L'AquilaItaly
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3
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Guzmán DC, Brizuela NO, Herrera MO, Peraza AV, Garcia EH, Mejía GB, Olguin HJ. Assessment of the Roles of Magnesium and Zinc in Clinical Disorders. Curr Neurovasc Res 2023; 20:505-513. [PMID: 38037909 DOI: 10.2174/0115672026275688231108184457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 12/02/2023]
Abstract
The ability and facility of magnesium (Mg2+) and zinc (Zn2+) to interact with phosphate ions confer them the characteristics of essential trace elements. Trace elements are extremely necessary for the basic nucleic acid chemistry of cells of all known living organisms. More than 300 enzymes require zinc and magnesium ions for their catalytic actions, including all the enzymes involved in the synthesis of ATP. In addition, enzymes such as isomerases, oxidoreductases, lyases, transferases, ligases and hydrolases that use other nucleotides to synthesize DNA and RNA require magnesium and zinc. These nucleotides may trigger oxidative damage or important changes against free radicals. In the same way, nucleotides may play an important role in the pathophysiology of degenerative diseases, including in some clinical disorders, where vascular risk factors, oxidative stress and inflammation work to destabilize the patients` homeostatic equilibrium. Indeed, reduced levels of zinc and magnesium may lead to inadequate amount of antioxidant enzymes, and thus, acts as an important contributing factor for the induction of oxidative stress leading to cellular or tissue dysfunction. Hence, the development of zinc or magnesium enzyme inhibitors could be a novel opportunity for the treatment of some human disorders. Therefore, the objective of the present work was to assess the clinical benefits of zinc and magnesium in human health and their effects in some clinical disorders.
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Affiliation(s)
- David Calderón Guzmán
- Laboratory of Neurosciences, Instituto Nacional de Pediatría (INP). Mexico City, CP 04530, Mexico
| | - Norma Osnaya Brizuela
- Laboratory of Neurosciences, Instituto Nacional de Pediatría (INP). Mexico City, CP 04530, Mexico
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Wu J, Liu C, Xie L, Li X, Xiao K, Xie G, Xie F. Early prediction of moderate-to-severe condition of inhalation-induced acute respiratory distress syndrome via interpretable machine learning. BMC Pulm Med 2022; 22:193. [PMID: 35550064 PMCID: PMC9098141 DOI: 10.1186/s12890-022-01963-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 04/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Several studies have investigated the correlation between physiological parameters and the risk of acute respiratory distress syndrome (ARDS), in addition, etiology-associated heterogeneity in ARDS has become an emerging topic quite recently; however, the intersection between the two, which is early prediction of target conditions in etiology-specific ARDS, has not been well-studied. We aimed to develop and validate a machine-learning model for the early prediction of moderate-to-severe condition of inhalation-induced ARDS. Methods Clinical expertise was applied with data-driven analysis. Using data from electronic intensive care units (retrospective derivation cohort) and the three most accessible vital signs (i.e. heart rate, temperature, and respiratory rate) together with feature engineering, we applied a random forest approach during the time window of 90 h that ended 6 h prior to the onset of moderate-to-severe respiratory failure (the ratio of partial pressure of arterial oxygen to fraction of inspired oxygen ≤ 200 mmHg). Results The trained random forest classifier was validated using two independent validation cohorts, with an area under the curve of 0.9127 (95% confidence interval 0.8713–0.9542) and 0.9026 (95% confidence interval 0.8075–1), respectively. A Stable and Interpretable RUle Set (SIRUS) was used to extract rules from the RF to provide guidelines for clinicians. We identified several predictive factors, including resp_96h_6h_min < 9, resp_96h_6h_mean ≥ 16.1, HR_96h_6h_mean ≥ 102, and temp_96h_6h_max > 100, that could be used for predicting inhalation-induced ARDS (moderate-to-severe condition) 6 h prior to onset in critical care units. (‘xxx_96h_6h_min/mean/max’: the minimum/mean/maximum values of the xxx vital sign collected during a 90 h time window beginning 96 h prior to the onset of ARDS and ending 6 h prior to the onset from every recorded blood gas test). Conclusions This newly established random forest‑based interpretable model shows good predictive ability for moderate-to-severe inhalation-induced ARDS and may assist clinicians in decision-making, as well as facilitate the enrolment of patients in prevention programmes to improve their outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01963-7.
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Affiliation(s)
- Junwei Wu
- Library of Graduate School, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Chao Liu
- Ping An Healthcare Technology, Beijing, China.,Yidu Cloud Technology Inc, Beijing, China
| | - Lixin Xie
- College of Pulmonary and Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Xiang Li
- Ping An Healthcare Technology, Beijing, China
| | - Kun Xiao
- College of Pulmonary and Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing, 100853, China
| | - Guotong Xie
- Ping An Healthcare Technology, Beijing, China. .,Ping An Health Cloud Company Limited, Beijing, China. .,Ping An International Smart City Technology Co., Ltd., Beijing, China.
| | - Fei Xie
- College of Pulmonary and Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
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Zamai L. Upregulation of the Renin-Angiotensin System Pathways and SARS-CoV-2 Infection: The Rationale for the Administration of Zinc-Chelating Agents in COVID-19 Patients. Cells 2021; 10:506. [PMID: 33673459 PMCID: PMC7997276 DOI: 10.3390/cells10030506] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/12/2022] Open
Abstract
The article describes the rationale for the administration of zinc-chelating agents in COVID-19 patients. In a previous work I have highlighted that the binding of the SARS-CoV spike proteins to the zinc-metalloprotease ACE2 has been shown to induce ACE2 shedding by activating the zinc-metalloprotease ADAM17, which ultimately leads to systemic upregulation of ACE2 activity. Moreover, based on experimental models, it was also shown the detrimental effect of the excessive systemic activity of ACE2 through its downstream pathways, which leads to "clinical" manifestations resembling COVID-19. In this regard, strong upregulation of circulating ACE2 activity was recently reported in COVID-19 patients, thus supporting the previous hypothesis that COVID-19 may derive from upregulation of ACE2 activity. Based on this, a reasonable hypothesis of using inhibitors that curb the upregulation of both ACE2 and ADAM17 zinc-metalloprotease activities and consequent positive feedback-loops (initially triggered by SARS-CoV-2 and subsequently sustained independently on viral trigger) is proposed as therapy for COVID-19. In particular, zinc-chelating agents such as citrate and ethylenediaminetetraacetic acid (EDTA) alone or in combination are expected to act in protecting from COVID-19 at different levels thanks to their both anticoagulant properties and inhibitory activity on zinc-metalloproteases. Several arguments are presented in support of this hypothesis and based on the current knowledge of both beneficial/harmful effects and cost/effectiveness, the use of chelating agents in the prevention and therapy of COVID-19 is proposed. In this regard, clinical trials (currently absent) employing citrate/EDTA in COVID-19 are urgently needed in order to shed more light on the efficacy of zinc chelators against SARS-CoV-2 infection in vivo.
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Affiliation(s)
- Loris Zamai
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy;
- National Institute for Nuclear Physics (INFN)-Gran Sasso National Laboratory (LNGS), Assergi, 67100 L’Aquila, Italy
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6
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Zamai L. The Yin and Yang of ACE/ACE2 Pathways: The Rationale for the Use of Renin-Angiotensin System Inhibitors in COVID-19 Patients. Cells 2020; 9:E1704. [PMID: 32708755 PMCID: PMC7408073 DOI: 10.3390/cells9071704] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/10/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023] Open
Abstract
The article describes the rationale for inhibition of the renin-angiotensin system (RAS) pathways as specific targets in patients infected by SARS-CoV-2 in order to prevent positive feedback-loop mechanisms. Based purely on experimental studies in which RAS pathway inhibitors were administered in vivo to humans/rodents, a reasonable hypothesis of using inhibitors that block both ACE and ACE2 zinc metalloproteases and their downstream pathways in COVID-19 patients will be proposed. In particular, metal (zinc) chelators and renin inhibitors may work alone or in combination to inhibit the positive feedback loops (initially triggered by SARS-CoV-2 and subsequently sustained by hypoxia independently on viral trigger) as both arms of renin-angiotensin system are upregulated, leading to critical, advanced and untreatable stages of the disease.
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Affiliation(s)
- Loris Zamai
- Department of Biomolecular Sciences, University of Urbino “Carlo Bo”, 61032 Urbino, Italy; ; Tel.: +39-0722-304319
- INFN-Gran Sasso National Laboratory, Assergi, 67100 L’Aquila, Italy
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Xie X, Zhao J, Xie L, Wang H, Xiao Y, She Y, Ma L. Identification of differentially expressed proteins in the injured lung from zinc chloride smoke inhalation based on proteomics analysis. Respir Res 2019; 20:36. [PMID: 30770755 PMCID: PMC6377712 DOI: 10.1186/s12931-019-0995-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
Background Lung injury due to zinc chloride smoke inhalation is very common in military personnel and leads to a high incidence of pulmonary complications and mortality. The aim of this study was to uncover the underlying mechanisms of lung injury due to zinc chloride smoke inhalation using a rat model. Methods: Histopathology analysis of rat lungs after zinc chloride smoke inhalation was performed by using haematoxylin and eosin (H&E) and Mallory staining. A lung injury rat model of zinc chloride smoke inhalation (smoke inhalation for 1, 2, 7 and 14 days) was developed. First, isobaric tags for relative and absolute quantization (iTRAQ) and weighted gene co-expression network analysis (WGCNA) were used to identify important differentially expressed proteins. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were used to study the biological functions of differentially expressed proteins. Then, analysis of lung injury repair-related differentially expressed proteins in the early (day 1 and day 2) and middle-late stages (day 7 and day 14) of lung injury after smoke inhalation was performed, followed by the protein-protein interaction (PPI) analysis of these differentially expressed proteins. Finally, the injury repair-related proteins PARK7 and FABP5 were validated by immunohistochemistry and western blot analysis. Results Morphological changes were observed in the lung tissues after zinc chloride smoke inhalation. A total of 27 common differentially expressed proteins were obtained on days 1, 2, 7 and 14 after smoke inhalation. WGCNA showed that the turquoise module (which involved 909 proteins) was most associated with smoke inhalation time. Myl3, Ckm, Adrm1 and Igfbp7 were identified in the early stages of lung injury repair. Gapdh, Acly, Tnni2, Acta1, Actn3, Pygm, Eno3 and Tpi1 (hub proteins in the PPI network) were identified in the middle-late stages of lung injury repair. Eno3 and Tpi1 were both involved in the glycolysis/gluconeogenesis signalling pathway. The expression of PARK7 and FABP5 was validated and was consistent with the proteomics analysis. Conclusion The identified hub proteins and their related signalling pathways may play crucial roles in lung injury repair due to zinc chloride smoke inhalation.
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Affiliation(s)
- Xiaowei Xie
- Medical School of Chinese PLA, Medical School of Chinese PLA, Fuxing Road, Beijing, 100853, China
| | - Jingan Zhao
- Medical School of Chinese PLA, Medical School of Chinese PLA, Fuxing Road, Beijing, 100853, China
| | - Lixin Xie
- Medical School of Chinese PLA, Medical School of Chinese PLA, Fuxing Road, Beijing, 100853, China.
| | - Haiyan Wang
- Department of Respiratory, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yan Xiao
- Department of Respiratory, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yingjia She
- Department of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
| | - Lingyun Ma
- Department of Respiratory, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
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Calderón Guzmán D, Juárez Olguín H, Osnaya Brizuela N, Hernández Garcia E, Lindoro Silva M. The Use of Trace and Essential Elements in Common Clinical Disorders: Roles in Assessment of Health and Oxidative Stress Status. Nutr Cancer 2019; 71:13-20. [PMID: 30663392 DOI: 10.1080/01635581.2018.1557214] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
During the early life, the diet of infants is mainly dominated by milk. Milk is a natural food rich in trace elements focus on essential elements. These elements are very necessary for human metabolism and since they cannot be synthesized by the body, the only source available for the humans to obtain them is by ingestion of natural food. This mini-review aims at updating the knowledge on trace elements, outlining their natural food sources, and their possible implications in common clinical disorders in early and adult life. However, it was found that consumption of food with micronutrients and trace elements may release intracellular compounds and offer oxidative protection or exacerbate oxidative damage to metabolically compromised cells.
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Affiliation(s)
- David Calderón Guzmán
- a Laboratorio de Neurociencias, Instituto Nacional de Pediatría (INP), Mexico City, Mexico
| | - Hugo Juárez Olguín
- b Laboratorio de Farmacología, INP and Facultad de Medicina , Universidad Nacional Autónoma de México , Mexico City , Mexico
| | - Norma Osnaya Brizuela
- a Laboratorio de Neurociencias, Instituto Nacional de Pediatría (INP), Mexico City, Mexico
| | - Ernestina Hernández Garcia
- b Laboratorio de Farmacología, INP and Facultad de Medicina , Universidad Nacional Autónoma de México , Mexico City , Mexico
| | - Miroslava Lindoro Silva
- b Laboratorio de Farmacología, INP and Facultad de Medicina , Universidad Nacional Autónoma de México , Mexico City , Mexico
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Cui P, Xin H, Yao Y, Xiao S, Zhu F, Gong Z, Tang Z, Zhan Q, Qin W, Lai Y, Li X, Tong Y, Xia Z. Human amnion-derived mesenchymal stem cells alleviate lung injury induced by white smoke inhalation in rats. Stem Cell Res Ther 2018; 9:101. [PMID: 29650044 PMCID: PMC5898065 DOI: 10.1186/s13287-018-0856-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/17/2018] [Accepted: 03/26/2018] [Indexed: 02/08/2023] Open
Abstract
Background White smoke inhalation (WSI) is an uncommon but potentially deadly cause of acute lung injury and acute respiratory distress syndrome for which no effective pharmaceutical treatment has been developed. This study aimed to determine the protective effects of human amnion-derived mesenchymal stem cells (hAMSCs) against WSI-induced lung injury in rats. Methods hAMSCs were injected into rats via the tail vein 4 h after WSI. At 1, 3, 7, 14, and 28 days after cell injection, hAMSCs labeled with PKH26 in lung, heart, liver, and kidney tissues were observed by fluorescence microscopy. The lung injury score was determined by hematoxylin and eosin staining. Lung fibrosis was assessed by Masson’s trichrome staining. The computed tomography (CT) score was assessed by CT scanning. The wet/dry weight ratio was calculated. The levels of interleukin (IL)-1β, IL-6, and IL-10 were determined by enzyme-linked immunosorbent assays. The expression of surfactant protein (SP)-A, SP-C, and SP-D was measured by Western blotting. Results The injected hAMSCs were primarily distributed in the lung tissues in WSI-induced rats. Compared with the model and phosphate-buffered saline (PBS) group, hAMSC treatment led to reduced lung injury, lung fibrosis, CT score, and inflammation levels in WSI-induced mice. hAMSC treatment also resulted in increased cell retention in the lung, partial pressure of oxygen (PaO2), and PaO2/fraction of inspired oxygen (FiO2) levels, and pulmonary SP-A, SP-C, and SP-D expression compared with that in the model and PBS group. Conclusions hAMSCs are a potential cell-based therapy for WSI-induced lung injury.
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Affiliation(s)
- Pei Cui
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Haiming Xin
- Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Yongming Yao
- Trauma Research Center, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, 100048, People's Republic of China
| | - Shichu Xiao
- Department of Burn surgery, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, China
| | - Feng Zhu
- Department of Burn surgery, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, China
| | - Zhenyu Gong
- Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Zhiping Tang
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Qiu Zhan
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Wei Qin
- Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Yanhua Lai
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Xiaohui Li
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Yalin Tong
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China. .,Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China.
| | - Zhaofan Xia
- Department of Burn surgery, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, China.
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