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Yang GB, Hu FL, Cheng W, Gao JQ, Sheng ZY, Zhang YJ, Du XL, Zuo Y, Li Y, Chen BM, Wang ZH, Zhao Z. [A multi-center, randomized controlled study on the effect of Saccharomyces boulardii combined with triple therapy for the initial eradication of Helicobacter pylori infection]. Zhonghua Yi Xue Za Zhi 2022; 102:1383-1388. [PMID: 35545584 DOI: 10.3760/cma.j.cn112137-20210811-01790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To assess the efficacy and safety of Saccharomyces boulardii (S. boulardii) in combination with triple therapy as a first-line regimen for the eradication of Helicobacter pylori (H. pylori) in non-ulcer dyspepsia (NUD) patients. Methods: A total of 497 Helicobacter pylori-positive patients who underwent gastroscopy and diagnosed with NUD were enrolled from June 2018 to January 2020 in 9 medical centers across China. Participants were segmentedly randomly divided into 3 groups. Patients in group A received S. boulardii for 14 days and triple therapy for 10 days, while patients in group B received bismuth quadruple group for 10 days, and patients in group C received triple therapy for 10 days. The H. pylori status was determined by the 13C-urea breath test on the 44th day of the treatment. Symptom improvement and adverse reactions were assessed on the 14th and 44th day. Results: There were 229 males and 268 females in all 497 patients enrolled. They were aged 18-69 (46.1±11.8) years and 472 of them (158 cases in group A, 159 cases in group B, and 155 cases in group C) completed the trial. The intention-to-treat (ITT) eradication rates in patients in patients A, B and C were 77.8% (126/162), 80.1% (137/171) and 65.2% (107/164) respectively, and per protocol-based (PP) eradication rates were 79.7% (126/158), 86.2% (137/159) and 69.0% (107/155) respectively. The differences were statistically significant in ITT and PP analysis among 3 groups (ITT: χ²=11.14, P<0.01; PP: χ²=13.86, P<0.01). There was no significant difference between eradication rates of two quadruple therapys(all P>0.05), but both of them were significantly higher than that of standard triple therapy (both P<0.05). Statistics revealed that both quadruple therapys led to significantly higher symptom improvement of belching compared with that of standard triple therapy in day 14 (P<0.05). The relief of abdominal distension and belching symptom scores of group A were significantly higher than those of group C in day 44(all P<0.05). There was no serious adverse event reported. The incidence of diarrhea in group A was significantly lower than those in the other two groups (both P<0.05). Conclusions: The combination of S. boulardii and triple therapy can achieve a better eradication effect on H. pylori infection with NUD, and has advantages in symptom relief and safety.
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Affiliation(s)
- G B Yang
- Department of Gastroenterology, Aerospace Center Hospital, Beijing 100049, China
| | - F L Hu
- Department of Gastroenterology, First Hospital of Beijing University, Beijing 100034, China
| | - W Cheng
- Department of Gastroenterology, First Hospital of Beijing University, Beijing 100034, China
| | - J Q Gao
- Department of Gastroenterology, First Hospital of Beijing University, Beijing 100034, China
| | - Z Y Sheng
- Department of Gastroenterology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
| | - Y J Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing 210006, China
| | - X L Du
- Department of Gastroenterology, Changhai Hospital Affiliated to Naval Medical University, Shanghai 200433, China
| | - Y Zuo
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Y Li
- Department of Gastroenterology, Shengjing Hospital Affiliated to China Medical University, Shenyang 110801, China
| | - B M Chen
- Department of Gastroenterology, Southern Hospital Affiliated to Southern Medical University, Guangzhou 510515, China
| | - Z H Wang
- Department of Gastroenterology, General Hospital of Tianjin Medical University, Tianjin 300052, China
| | - Zihan Zhao
- Department of Gastroenterology, Aerospace Center Hospital, Beijing 100049, China
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Sheng ZY, Li M, Yang R, Liu YH, Yin XX, Mao JR, Brown HE, Zhou HN, Wang PG, An J. COVID-19 prevention measures reduce dengue spread in Yunnan Province, China, but do not reduce established outbreak. Emerg Microbes Infect 2021; 11:240-249. [PMID: 34935597 PMCID: PMC8745368 DOI: 10.1080/22221751.2021.2022438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The COVID-19 pandemic and measures against it provided a unique opportunity to understand the transmission of other infectious diseases and to evaluate the efficacy of COVID-19 prevention measures on them. Here we show a dengue epidemic in Yunnan, China, during the pandemic of COVID-19 was dramatically reduced compared to non-pandemic years and, importantly, spread was confined to only one city, Ruili. Three key features characterized this dengue outbreak: (i) the urban-to-suburban spread was efficiently blocked; (ii) the scale of epidemic in urban region was less affected; (iii) co-circulation of multiple strains was attenuated. These results suggested that countermeasures taken during COVID-19 pandemic are efficient to prevent dengue transmission between cities and from urban to suburban, as well to reduce the co-circulation of multiple serotypes or genotypes. Nevertheless, as revealed by the spatial analysis, once the dengue outbreak was established, its distribution was very stable and resistant to measures against COVID-19, implying the possibility to develop a precise prediction method.
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Affiliation(s)
- Z Y Sheng
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, PR China
| | - M Li
- Yunnan Provincial Key Laboratory of Vector-borne Disease Control and Research, Yunnan Institute of Parasitic Diseases, Simao Pu'er, Yunnan, PR China
| | - R Yang
- Yunnan Provincial Key Laboratory of Vector-borne Disease Control and Research, Yunnan Institute of Parasitic Diseases, Simao Pu'er, Yunnan, PR China
| | - Y H Liu
- Ruili Center of Disease Prevention and Control, Ruili, Yunnan, PR China
| | - X X Yin
- Ruili Center of Disease Prevention and Control, Ruili, Yunnan, PR China
| | - J R Mao
- Ruili People's Hospital, Ruili, Yunnan, PR China
| | - Heidi E Brown
- Department of Epidemiology and Biostatistics, College of Public Health, University of Arizona
| | - H N Zhou
- Yunnan Provincial Key Laboratory of Vector-borne Disease Control and Research, Yunnan Institute of Parasitic Diseases, Simao Pu'er, Yunnan, PR China
| | - P G Wang
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, PR China
| | - J An
- Department of Microbiology, School of Basic Medical Sciences, Capital Medical University, Beijing, PR China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing, China
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3
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Fei X, Sheng ZY, Yao YM. [Update in immune regulatory dysfunction of dendritic cells in sepsis]. Zhonghua Shao Shang Za Zhi 2020; 36:150-155. [PMID: 32114736 DOI: 10.3760/cma.j.issn.1009-2587.2020.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Further development of sepsis usually leads to septic shock or even death. Many previous studies have focused on the abnormal reactions of monocytes/macrophages, neutrophils, complement system, or cytokine inflammation in sepsis. Many evidences in recent years suggest that dendritic cells, as the most powerful antigen-presenting cells in innate immune system of body, play important role during the process of immune disorders of sepsis. In this article, I review the main classification, immune function, monitoring method, regulatory pathways of dendritic cells and their clinical significance in immune disorders of sepsis, so as to find new strategies for immune regulation of sepsis.
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Affiliation(s)
- X Fei
- Trauma Research Center, the Fourth Medical Center of PLA General Hospital, Beijing 100048, China
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4
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Lillie M, Sheng ZY, Honaker CF, Andersson L, Siegel PB, Carlborg Ö. Genomic signatures of 60 years of bidirectional selection for 8-week body weight in chickens. Poult Sci 2018; 97:781-790. [PMID: 29272516 DOI: 10.3382/ps/pex383] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 11/27/2017] [Indexed: 12/30/2022] Open
Abstract
Sixty years, constituting 60 generations, have passed since the founding of the Virginia body weight lines, an experimental population of White Plymouth Rock chickens. Using a stringent breeding scheme for divergent 8-week body weight, the lines, which originated from a common founder population, have responded to bidirectional selection with an approximate 15-fold difference in the selected trait. They provide a model system to study the genetics of complex traits in general and the influences of artificial selection on quantitative genetic architectures in particular. As we reflect on the 60th anniversary of the initiation of the Virginia body weight lines, there is opportunity to discuss the findings obtained using different analytical and experimental genetic and genomic strategies and integrate them with a recent pooled genome resequencing dataset. Hundreds of regions across the genome show differentiation between the 2 lines, reinforcing previous findings that response to selection relied on standing variation across many genes and giving insights into the haplotype complexity underlying regions associated with body weight.
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Affiliation(s)
- M Lillie
- Department of Medical Biochemistry and Microbiology, Genomics, Uppsala University, Uppsala, Sweden
| | - Z Y Sheng
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, People's Republic of China
| | - C F Honaker
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg
| | - L Andersson
- Department of Medical Biochemistry and Microbiology, Genomics, Uppsala University, Uppsala, Sweden.,Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Department of Veterinary Integrative Biosciences, Texas A&M University, College Station
| | - P B Siegel
- Department of Animal and Poultry Sciences, Virginia Polytechnic Institute and State University, Blacksburg
| | - Ö Carlborg
- Department of Medical Biochemistry and Microbiology, Genomics, Uppsala University, Uppsala, Sweden
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Luan YY, Yao YM, Sheng ZY. The tumor necrosis factor-alpha-induced protein 8 family in immune homeostasis and inflammatory cancer diseases. J BIOL REG HOMEOS AG 2013; 27:611-619. [PMID: 24152830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Within the immune system homeostasis is maintained by a myriad of mechanisms that include the regulation of immune cell activation and programmed cell death. The breakdown of immune homeostasis may lead to fatal inflammatory diseases. We set out to identify genes of tumor necrosis factor-alpha-induced protein 8 (TNFAIP8) family that has a functional role in the process of immune homeostasis. Tumor necrosis factor-alpha-induced protein 8 (TNFAIP8), which functions as an oncogenic molecule, is also associated with enhanced cell survival and inhibition of apoptosis. Tumor necrosis factor-alpha-induced protein 8-like 2 (TIPE2) governs immune homeostasis in both the innate and adaptive immune system and prevents hyper-responsiveness by negatively regulating signaling via T cell receptors and Toll-like receptors (TLRs). There also exist two highly homologous but uncharacterized proteins, TIPE1 and TIPE3. This review is an attempt to provide a summary of TNFAIP8 family associated with immune homeostasis and inflammatory cancer diseases.
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Affiliation(s)
- Y Y Luan
- Department of Microbiology and Immunology, Burns Institute, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, People's Republic of China
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6
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Fu XB, Wang ZG, Sheng ZY. [The current condition and research progress of normal wound repair and "un-controlled" wound repair]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2001; 15:385-8. [PMID: 11762231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE To describe the concept of "un-controlled wound repair" and review its current progress in basic research and clinical treatment. METHODS The literature review and comprehensive analysis methods were used in this study. RESULTS The results showed that the normal wound repair and "un-controlled" wound repair had made big progress in cellular, molecular and genetic levels in recent years and these progresses had enhanced the treatment progress in clinic. CONCLUSION All data indicate that the wound repair is made a big progress both in basic and clinic fields. New high techniques, such as clone, biochip and stem cell and their use will promote the deep study of "un-controlled" wound repair.
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Affiliation(s)
- X B Fu
- 304th Hospital of PLA, Beijing, P. R. China 100037
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7
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Zhang YD, Hou SX, Zhang WJ, Sheng ZY. Pathomorphological and quantitative bacteriological findings in various forms of primary surgery on gunshot wounds of extremities. Arch Orthop Trauma Surg 2001; 121:566-70. [PMID: 11768637 DOI: 10.1007/s004020100268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
It is well-known that 'wound excision' is essential in the primary treatment of wounds in war, particularly thorough debridement of the devitalized tissues around the path of a penetrating projectile. Nowadays, the gunshot wounds in peacetime have become prevalent. Instead of the traditional method of 'wound excision' (excision), we used the method of 'incision and drainage' (incision) in the primary surgery of these gunshot wounds of extremities. To determine the treatment effectiveness of these different surgical methods (incision and excision), two groups of dogs were shot in the proximal part of one hind leg with an American M-16 rifle. One group was treated by the method of 'excision'; in the other group 'incision' were performed. No difference in infection rate was noted between the two groups. Similarly, no difference in bacterial count was found between the two groups during the observation period. Also, there was no difference in healing time; the wounds in both groups had healed by 19.2-21.4 days. Microscopic examination revealed a little normal muscle tissue in the necrotic zone of the incision group which might augment the repair process. These results suggest that there are no differences in the effectiveness in preventing infection between the two methods. 'Incision' might be superior to 'excision' for the management of the gunshot wounds of extremities in peacetime, as it involves a simple operation and there are advantages for tissue healing.
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Affiliation(s)
- Y D Zhang
- Orthopaedic Center, 304th Hospital of Postgraduate Medical College, Beijing, China
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8
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Abstract
AIM: To explore the kinetic changes in plasma D(-)-lactate and lipopolysaccharide (LPS) levels, and investigate whether D(-)-lactate could be used as a marker of intestinal injury in rats following gut ischemia/reperfusion, burn, and acute necrotizing pancreatitis (ANP).
METHODS: Three models were developed in rats: ① gut ischemia/reperfusion obtained by one hour of superior mesenteric artery occlusion followed by reperfusion; ② severe burn injury created by 30% of total body surface area (TBSA) full-thickness scald burn; and ③ ANP induced by continuous inverse infusion of sodium taurocholate and trypsin into main pancreatic duct. Plasma levels of D(-)-lactate in systemic circulation and LPS in portal circulation were measured by enzymatic-spectrophotometric method and limulus amebocyte lysate (LAL) test kit, respectively. Tissue samples of intestine were taken for histological analysis.
RESULTS: One hour gut ischemia followed by reperfusion injuries resulted in a significant elevation in plasma D(-)-lactate and LPS levels, and there was a significant correlation between the plasma D(-)-lactate and LPS (r = 0.719, P < 0.05). The plasma concentrations of D(-)-lactate and LPS increased significantly at 6 h postburn, and there was also a remarkable correlation between them (r = 0.877, P < 0.01). D(-)-lactate and LPS levels elevated significantly at 2 h after ANP, with a similar significant correlation between the two levels (r = 0.798, P < 0.01). The desquamation of intestine villi and infiltration of inflammatory cells in the lamina propria were observed in all groups.
CONCLUSION: The changes of plasma D(-)-lactate levels in systemic blood paralleled with LPS levels in the portal vein blood. The measurement of plasma D(-)-lactate level may be a useful marker to assess the intestinal injury and to monitor an increase of intestinal permeability and endotoxemia following severe injuries in early stage.
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Affiliation(s)
- X Q Sun
- Burn Institute, Trauma Center, 304th Hospital, Beijing 100037, China. fu
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9
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Fang WH, Yao YM, Shi ZG, Yu Y, Wu Y, Lu LR, Sheng ZY. Effect of recombinant bactericidal/permeability-increasing protein on endotoxin translocation and lipopolysaccharide-binding protein/CD14 expression in rats after thermal injury. Crit Care Med 2001; 29:1452-9. [PMID: 11445707 DOI: 10.1097/00003246-200107000-00025] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the potential mechanisms underlying the in vivo effect of recombinant bactericidal/permeability-increasing protein (rBPI21) on endogenous bacteria or endotoxin translocation and lipopolysaccharide-binding protein/CD14 expression secondary to thermal injury. DESIGN Prospective, randomized, controlled animal study. SETTING College hospital animal research laboratory. SUBJECTS Thirty-six male Wistar rats weighing 250-300 g. INTERVENTIONS The rats were anesthetized, and a 35% total body surface area full-thickness burn was created. Animals were randomized to receive treatment with either rBPI21 or the control protein (albumin). rBPI21 (2 mg/kg body wt, BPI group) or a protein control preparation (burn group) in the same dose was administered in an intravenous bolus at 30 mins and 4 hrs after thermal injury. All animals were killed at 12 and 24 hrs postburn (six to ten rats for each interval). In addition, eight rats were taken as normal controls. MEASUREMENT AND MAIN RESULTS Our data showed that treatment with rBPI21 was effective in preventing endotoxin translocation secondary to severe burns. Meanwhile, tissue lipopolysaccharide-binding protein, CD14, and tumor necrosis factor-alpha mRNA expression in various organs were inhibited markedly by rBPI21 secondary to acute insults (p <.05-.01). Furthermore, significant reduction in serum aminoleucine transferase concentrations and elevation in intestinal diamine oxidase activities in the rBPI21-treated group were found compared with controls (p <.05-.01). CONCLUSIONS These findings indicate that endotoxin accumulated in local sites after thermal injury can markedly up-regulate lipopolysaccharide-binding protein/CD14 and tumor necrosis factor-alpha mRNA expression in various organs. Meanwhile, up-regulation of lipopolysaccharide-binding protein/CD14 expression would be the major molecular mechanism of increasing sensitivity to endogenous endotoxin response after burns. Early treatment with rBPI21may be effective in attenuating multiple organ damage resulting from gut-origin endotoxin translocation. This might be associated with the down-regulation effects of tissue lipopolysaccharide-binding protein and CD14 gene expression by the use of rBPI21.
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Affiliation(s)
- W H Fang
- Department of Microbiology and Immunology, Trauma Research Center, Postgraduate Medical College, 304th Hospital, Beijing, People's Republic of China
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10
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Fu XB, Guo ZR, Sheng ZY. [Effects of basic fibroblast growth factor on the healing of cutaneous chronic wounds]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 1999; 13:270-2. [PMID: 12080816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To observe the effects of basic fibroblast growth factor(bFGF) on the healing of cutaneous chronic wounds. METHODS Twenty-eight cases with thirty-three wounds from trauma, diabetes, pressure and radiation injuries were locally treated with bFGF in a dosage of 150 U/cm2 wounds. The healing time of wounds was used to evaluate the treatment results. RESULTS The healing time in all of chronic wounds were accelerated. All wounds from trauma, diabetes and pressure were healed within 4 weeks and another 2 wounds from radiation injuries were healed over 4 weeks. The healing rate within 4 weeks was 93.9%. CONCLUSION The results indicate that bFGF can be used as a promoter to accelerate the healing of chronic wounds in clinic.
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Affiliation(s)
- X B Fu
- 304th Hospital of PLA, Beijing, P. R. China 100037
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11
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Sheng ZY. [A new concept for drugs to reduce fever and inflammation]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1997; 17:628-9. [PMID: 10322896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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12
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Yao YM, Lu LR, Yu Y, Liang HP, Chen JS, Shi ZG, Zhou BT, Sheng ZY. Influence of selective decontamination of the digestive tract on cell-mediated immune function and bacteria/endotoxin translocation in thermally injured rats. J Trauma 1997; 42:1073-9. [PMID: 9210544 DOI: 10.1097/00005373-199706000-00015] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine the influence of pretreatment with selective decontamination of the digestive tract (SDD) on systemic immunosuppression, and the relationship between bacteria/endotoxin translocation and abnormalities of immune function in thermally injured rats. DESIGN, MATERIALS, AND METHODS Animals were subjected to a 40% full-thickness scald injury, and divided into SDD-treated and control groups. The treatment group received SDD (polymyxin E, tobramycin, and 5-flucytosine) by gavage twice daily for 3 days before the experiment and continued for 5 days after thermal injury. The control group was given the same amount of water. The parameters reflecting cell-mediated immunity, including splenocyte proliferation in response to mitogens, interleukin 2 (IL-2) production, and lymphocyte subpopulation, were measured before injury and 1 and 5 days after burn, respectively. MEASUREMENTS AND MAIN RESULTS Thermal injury resulted in marked reduction in splenocyte proliferative response to T-cell mitogens, IL-2 production, and T-helper/suppressor cells (CD4/CD8) ratio. Prophylactic treatment with SDD significantly decreased the incidences of bacterial translocation and endotoxemia, prevented suppressive mitogenic response and inadequate IL-2 production (p < 0.05-0.01) but did not affect the abnormal ratio of CD4 to CD8 T lymphocytes in blood (p > 0.05). CONCLUSIONS These results suggest that bacteria/endotoxin translocation from the gut appears to be involved in cell-mediated immune dysfunction as a consequence of thermal injury. Pretreatment with SDD might attenuate postburn immunosuppression by preventing translocation events.
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Affiliation(s)
- Y M Yao
- Trauma Research Center, Postgraduate Medical College, 304th Hospital, Beijing, People's Republic of China
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Abstract
The present study was conducted to determine the relationship between levels of neopterin and endotoxin in the circulation, and whether the neopterin level was related to the development of severe sepsis after extensive burns. This prospective study included 35 patients with burn size greater than 30% (30-98%), and 22 healthy volunteers who served as a comparison group. Neopterin levels increased in most patients on day 3 post-burn, but they were not significantly correlated with the extent of the burn surface (P > 0 center dot 05). A high serum neopterin level was found in patients with sepsis (n = 15), and a marked elevation persisted throughout the observation period. The difference between septic and non-septic patients (n = 20) became significant on 14 and 28 days post-burn. Although the presence of early endotoxaemia did not influence the alterations in serum neopterin, patients with endotoxaemia had much higher neopterin values than those who showed no endotoxaemia from the second week onward (P < 0 center dot 05-0 center dot 01). In addition, circulating endotoxin and neopterin levels were positively correlated in patients who developed endotoxaemia on day 14 (r = 0 center dot 368, P < 0 center dot 05) and day 21 (r = 0 center dot 439, P < 0 center dot 01) after major burns. These results suggest that thermal injury can lead to an elevation of serum neopterin independent of the burn surface area. The initial increase in the neopterin level may be a part of the acute-phase response to tissue injury itself, whereas the endotoxin release in the circulation may be responsible for the continuous induction of neopterin during the late stage. In addition, the presence of a constant high neopterin level is associated with a critical event in the development of severe burn sepsis.
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Affiliation(s)
- Y M Yao
- Trauma Center, Postgraduate Medical College, Beijing, China
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14
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Yu Y, Sheng ZY, Tian H. [An experimental study on injury of intestinal immuno-barrier in rat after scald]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi 1996; 12:86-9. [PMID: 9206144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A dynamic observation on injury of intestinal immuno-barrier in scalded rat was performed to investigate the relationship between the injury of intestinal immuno-barrier and bacterial translocation. After 40% TBSA third degree scald, a decrease of IgA in intestinal content and the number of CD3+ and CD4+ T lymphocyte, and reduction of IgA coat rate of intestinal bacteria were observed. At the same time, an increase in the incidence of bacterial translocation was detected. The results indicated that intestinal immuno-barrier was damaged and its protective function was weakened after an extensive thermal injury, and it suggested that the injury of intestinal immuno-barrier might play an important role on the development of postburn bacterial translocation and postburn sepsis.
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Affiliation(s)
- Y Yu
- Trauma Center, 304th Hospital of People's Liberation Army, Beijing
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15
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Yao YM, Wang YP, Tian HM, Yu Y, Chang GY, Shi ZG, Sheng ZY. Reduction of circulating prostaglandin E2 level by antiserum against core lipopolysaccharide in a rabbit model of multiple organ failure. J Trauma 1996; 40:270-7. [PMID: 8637078 DOI: 10.1097/00005373-199602000-00017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To determine the potential role of prostaglandin E2 (PGE2) in the development of multiple organ dysfunction or failure (MOF), the possible effects of antiserum directed against Re chemotype lipopolysaccharide (LPS, from Re mutant of Escherichia coli F515) on circulating PGE2 level and survival rate, and whether there is an elevation in the plasma LPS concentration that could account for the induction of arachidonic acid metabolite in a rabbit model of MOF caused by acute hypovolemic insult. DESIGN, MATERIALS, AND METHODS An animal model of MOF in rabbits, engendered by feeding live Escherichia coli O111:B4 before hemorrhagic shock (35-40 mm Hg for 60 min), was used in the present study. Re-LPS antiserum was given intravenously in the treatment group at the onset of hemorrhage and 4 hours after resuscitation. The animals that received equal volumes of normal rabbit serum and antiserum served as the control group. MEASUREMENTS AND MAIN RESULTS The circulating PGE2 level was not increased at the end of shock (p > 0.05), but it was found to be significantly elevated 24 hours after hemorrhage and resuscitation in both groups. However, Re-LPS antiserum administration markedly decreased peak PGE2 level (p < 0.05) and attenuated multiple organ damage caused by acute insult. Concomitantly, there were also lower LPS concentrations in the treatment group as compared with the control group (p < 0.05-0.01). The survival rate was significantly increased in antiserum-treated rabbits 96 hours postinjury (treatment vs. control: 58.0% vs. 11.1%, p < 0.01). CONCLUSIONS The results suggest that an excessive generation and release of PGE2 may be involved in the pathogenesis of immunosuppression and MOF following hemorrhage and resuscitation. Re-LPS antiserum has an inhibitory effect on overproduction of circulating PGE2 and the ability to improve survival with MOF. Gut-derived endotoxemia, bacterial translocation, or both, could account, at least in part, for the PGE2 formation and release in animals response to acute hypovolemic insult.
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Affiliation(s)
- Y M Yao
- Trauma Center of Postgraduate Medical College, 304th Hospital, Beijing, People's Republic of China
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Yao YM, Yu Y, Sheng ZY, Tian HM, Wang YP, Lu LR, Yu Y. Role of gut-derived endotoxaemia and bacterial translocation in rats after thermal injury: effects of selective decontamination of the digestive tract. Burns 1995; 21:580-5. [PMID: 8747729 DOI: 10.1016/0305-4179(95)00059-k] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
This study was performed to investigate: (1) the role of gut-derived endotoxin/bacterial translocation in the pathogenesis of sepsis, and (2) the possible effects of selective decontamination of the digestive tract (SDD) on mortality in rats following 40 per cent full-thickness scald injury. In the SDD-treated group, Enterobacteriaceae and yeasts were eradicated from the caecal mucosa, while the mucosal flora consisting of mainly anaerobes was well preserved, within 3 days. The incidence of bacterial translocation to the mesenteric lymph nodes (MLN) and viscerae was significantly lowered on postburn days 1, 3 and 5 (P < 0.05-0.01). Meanwhile, pretreatment with SDD resulted in reductions of the faecal endotoxin levels in different segments of intestinal tract to less than 0.5 per cent (0.04-0.45 per cent) of the untreated control; there was also a significant attenuation of the elevation of endotoxin concentrations in both portal and systemic blood. Intestinal diamine oxidase (DAO) activity returned to baseline on day 5 in rats receiving SDD but not in controls. The 5-day survival rate in the SDD-treated group was elevated by 26.7 per cent as compared with controls (P < 0.05). These data suggested that endotoxin/bacterial translocation took place early and commonly, which in turn contributed to postburn sepsis and mortality. SDD was effective in preventing gut origin endotoxaemia and bacterial translocation, and improving the survival rate in rats following severe thermal injuries.
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Affiliation(s)
- Y M Yao
- Trauma Center of Postgraduate Medical College, 304th Hospital, Beijing, PR China
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17
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Yao YM, Tian HM, Sheng ZY, Wang YP, Yu Y, Sun SR, Xu SH. Inhibitory effects of low-dose polymyxin B on hemorrhage-induced endotoxin/bacterial translocation and cytokine formation in rats. J Trauma 1995; 38:924-30. [PMID: 7602637 DOI: 10.1097/00005373-199506000-00018] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The current experiments were performed to determine the effects of a subtherapeutic dose of polymyxin B sulfate on gut origin endotoxemia/bacterial translocation, and tumor necrosis factor (TNF) and interleukin-1 (IL-1) release following hemorrhagic shock (30 mm Hg, 90 min) in rats. The results showed that significant portal and systemic endotoxemia took place in the control group (portal, 0.269 to 0.845 endotoxin units (EU)/mL; systemic, 0.164 to 0.655 EU/mL), but not in the treatment group (except 0.5 hour in portal blood: 0.207 +/- 0.094 EU/mL). Concomitantly, the incidence of bacterial translocation to the mesenteric lymph nodes and viscera were reduced significantly at 0.5, 2, 6, and 24 hours postresuscitation in animals receiving polymyxin B (p < 0.05 to 0.01), whereas there were no differences with respect to number of translocating bacteria between the two groups (p > 0.05). Marked elevation of plasma TNF levels and IL-1 activities of peritoneal macrophages were also found in untreated controls at 0.5 to 2 hours (p < 0.05) and 6 to 24 hours (p < 0.05 to 0.01), respectively, but prevented by administration of low-dose polymyxin B. The 48-hour survival rate was improved from 41.7% in the control group to 75.0% in the treatment ones (p > 0.05). These data suggest that pretreatment with a subtherapeutic dose of polymyxin B is effective to inhibit hemorrhage-induced endotoxin/bacterial translocation from the gut and excessive TNF and IL-1 production.
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Affiliation(s)
- Y M Yao
- Trauma Center, Postgraduate Medical College, 304th Hospital, Beijing, People's Republic of China
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18
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Yao YM, Sheng ZY, Tian HM, Yu Y, Wang YP, Yang HM, Guo ZR, Gao WY. The association of circulating endotoxaemia with the development of multiple organ failure in burned patients. Burns 1995; 21:255-8. [PMID: 7662124 DOI: 10.1016/0305-4179(95)93867-j] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In this study, we examined the relationship of plasma endotoxin levels to the development of multiple organ failure (MOF), and the outcome in patients with thermal injury. A prospective cohort study of 17 patients admitted with burns covering more than 70 per cent of body surface area was undertaken. Circulating endotoxin concentrations were measured by modified limulus amoebocyte lysate assay in serial samples of plasma. Seven out of 17 burned patients developed MOF according to multiple criteria. The plasma endotoxin concentrations of patients with MOF were 0.512-1.127 EU/ml, which were significantly higher than that of 10 patients without MOF (0.216-0.553 EU/ml), on 3, 14, 21 and 28 days postburn (p < 0.05-0.01). A significantly higher incidence of positive endotoxin tests (> or = 0.120 EU/ml) was found in patients who developed MOF as compared to those patients who did not develop MOF during the observation period (p < 0.05). As the mean endotoxin levels increased, the incidence of MOF and death rate also increased, and persistent endotoxemia carried a poor prognosis. The present investigation provides further evidence that endotoxemia in severely burned patients commonly occurs. Circulating endotoxin has also been found to be strongly associated with the development of MOF and mortality following major burn injury.
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Affiliation(s)
- Y M Yao
- Trauma Center of Postgraduate Medical College, 304th Hospital, Beijing, China
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19
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Yao YM, Sheng ZY, Tian HM, Wang YP, Yu Y, Fu XB, Lu LR, Wang DW, Ma YY. Gut-derived endotoxemia and multiple system organ failure following gunshot wounds combined with hemorrhagic shock: an experimental study in the dog. J Trauma 1995; 38:742-6. [PMID: 7760402 DOI: 10.1097/00005373-199505000-00011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The purpose of this study was to explore the causative effects of high-velocity bullet injury (5.56 mm, 930 m/sec) combined with hemorrhagic shock on gut-derived endotoxemia and multiple system organ dysfunction or failure. The concentration of endotoxin in both portal and systemic blood was markedly increased after gunshot wounds together with hemorrhagic shock (p < 0.05-0.01). The portal/systemic lipopolysaccharide ratio persistently decreased in the combined wound (CW) group at 24 to 72 hours after injury, and it was much lower in the CW group than that in the single gunshot wound (SW) group. Also, a significant increase of fecal endotoxin content was found in the CW group as compared to the SW group (118.30 +/- 75.36 vs. 8.89 +/- 3.32 micrograms/g, p < 0.01), which was paralleled with the population of gram-negative bacilli in the intestinal tract. The incidence of multiple system organ failure, multiorgan dysfunction (including single organ failure) in the CW group were 30.8% (4 of 13) and 38.5% (5 of 13), respectively. These results suggested that severe trauma could lead to gut origin endotoxemia and bacterial translocation, which might play an important role in the pathogenesis of sepsis and multiple system organ failure following gunshot wounds.
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Affiliation(s)
- Y M Yao
- Trauma Center of the Postgraduate Medical College, 304th Hospital, Beijing, China
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20
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Yao YM, Sheng ZY, Yu Y, Tian HM, Wang YP, Lu LR, Xu SH. The potential etiologic role of tumor necrosis factor in mediating multiple organ dysfunction in rats following intestinal ischemia-reperfusion injury. Resuscitation 1995; 29:157-68. [PMID: 7659869 DOI: 10.1016/0300-9572(95)00831-d] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Endogenous inflammatory cytokines may function as mediators in the development of remote organ damage in response to local ischemic insult. This study was designed to (a) explore the potential role of tumor necrosis factor (TNF) formation in the pathogenesis of systemic tissue injury, (b) determine the relationship between induction of TNF and gut-derived endotoxemia and/or bacterial translocation, and (c) evaluate the protective effect of anti-TNF monoclonal antibody (MoAb) for vital organs following intestinal ischemia-reperfusion in rats. Animals were subjected to superior mesenteric artery occlusion (SMAO) for 45 min. Systemic plasma TNF levels increased rapidly after the onset of reperfusion, reaching a peak value 2 h later (P < 0.01). TNF elevation was found to be associated with gut origin endotoxemia, where the maximal TNF levels occurred approximately 2 h after the initial appearance of endotoxin in portal vein. Prophylactic treatment with anti-TNF MoAb markedly blunted the elevation in plasma TNF levels and afforded protection from the development of hypotension, vital organs dysfunction, and metabolic acidosis. Significant improvement in 48-h survival rate was observed by administration of anti-TNF MoAb prior to inducing ischemia (P = 0.007). These findings suggest that intestinal ischemia-reperfusion could result in TNF production, which may play a key role in mediating subsequent septic response and systemic tissue injury. It seems likely that passage of endotoxin and bacteria from the gut can be responsible for the TNF formation
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Affiliation(s)
- Y M Yao
- Trauma Research Center, Postgraduate Medical College, 304th Hospital, Beijing, People's Republic of China
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21
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Yang HM, Guo ZR, Sheng ZY. [Delayed fluid resuscitation induced bacterial translocation after lethal thermal injury: role of oxygen free radical injury of intestinal mucosa]. Zhonghua Yi Xue Za Zhi 1994; 74:552-5, 583-4. [PMID: 7842355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The Present investigation was undertaken to examine the effect of delayed fluid resuscitation (DFR), after lethal thermal injury on oxygen free radical (OFR) injury of intestinal mucosa and its relationship to bacterial translocation. Four groups of gnotobiotic rats with 5 strains of bacteria were studied: sham injury group (control) (n = 6): early fluid resuscitation (EFR) group (n = 24) receiving resuscitation (Parkland) immediately after scald (40% TBSA, third degree); DFR group (n = 24) receiving resuscitation 6 hours after scald; treatment group (n = 12), rats with DFR receiving VitE and VitC treatment before resuscitation 12, 24, 48 and 72 hours after injury, animals (n = 6, at each point) were sacrificed. Plasma endotoxin level, mucosal SOD, GSHPx, MDA and diamine oxidase (DAO) of ileum were determined, and cultures of the mesenteric lymph nodes (MLN), liver, spleen, heart, lung, kidney and blood were done. The level of mucosal MDA and plasma endotoxin and the incidence of bacteria translocation (IBT) to tissues were significantly higher and mucosal SOD, GSHPx, DAO activity significantly lower in DFR group as compared with that in EFR group at most of the time points. In DFR group, mucosal MDA content was negatively correlated with mucosal DAO activity, which correlated positively with plasma endotoxin level and IBT. After treatment with VitE and VitC, mucosal MDA content was decreased, plasma endotoxin level and IBT were significantly decreased, and mucosal DAO activity was significantly increased. Our data indicated that DFR in cases of burn shock can result in OFR injury of intestinal mucosa, disrupting mucosal barrier and promoting translocation of intestinal bacteria and endotoxin.
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Affiliation(s)
- H M Yang
- Burn Unit, 304th Hospital of PLA, Beijing
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22
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Sheng ZY, Yang HM. The concept and diagnosis of multiple systems organ failure. Chin Med J (Engl) 1994; 107:563-9. [PMID: 7805437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
There are still controversies concerning the concept and diagnosis of multiple systems organ failure (MSOF), since the term does not precisely define its true nature, and its differential diagnosis with other irrelevant clinical conditions, such as senile dysfunction of organs, agonal state, etc, remains unclarified. Our studies on both human burn patients and rat model by means of electron spin resonance (ESR) showed that there was an excessive generation of free oxygen radicals resulting in lipid peroxidation of cell membrane of various tissues. The intestine seemed to be particularly sensitive to hypoperfusion-reperfusion injury, as diamine oxidase activity of the ileum was lowered and translocation of bacteria occurred, indicating failure of intestinal mucosal barrier function. Concomitant determinations of plasma endotoxin (LPS) and tumor necrosis factor alpha (TNFa) levels showed significant elevation, especially in patients who finally developed MSOF. The data suggested that intestinally derived bacteria and/or LPS exacerbate the systemic responses initiated by ischemia reperfusion injury and the presence of large amounts of devitalized tissue. Early diagnosis is important in order to improve the prognosis. However, current criteria of diagnosis for MSOF do not conduce to an early diagnosis, as they only describe the end stage manifestations, while our therapeutic strategy should be directed against different levels of initiators, systemic mediators, and effectors of injury. Therefore, it is important to emphasize the role of septic responses in the development of the syndrome. We propose that the name of the syndrome be changed to "sepsis with organ dysfunction" or "mediator injury of organs".
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Affiliation(s)
- Z Y Sheng
- Trauma Center, Postgraduate Medical College, 304th Hospital, Beijing
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23
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Guo ZR, Diao L, Sheng ZY. [Influential factors of water evaporation from burn wound]. Zhonghua Yi Xue Za Zhi 1994; 74:221-3, 255. [PMID: 7922763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
To determine various influential factors of water evaporation from burn wound, we scalded 120 rats and divided them randomly into 12 groups. The rate of evaporation was studied under different temperatures and moistures. The experimental results showed that high temperature and low moisture were beneficial to the treatment of burn wound. Escharectomy, skin grafting and film forming agents could reduce evaporation. Azone could change the permeability of the skin and accelerate water evaporation.
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Affiliation(s)
- Z R Guo
- 304th Hospital of PLA, Beijing
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24
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Cui XL, Guo ZR, Sheng ZY. [An efficacious topical agent--SD-Ag-azone cream]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi 1994; 10:5-6. [PMID: 8087694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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25
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Sheng ZY, Cai JK, Gu B. [Advances in burns and plastic surgery]. Zhonghua Yi Xue Za Zhi 1993; 73:726-7. [PMID: 8143177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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26
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Yao YM, Tian HM, Wang YP, Sheng ZY, Shi ZG, Xu SH. Protective effect of Re-LPS antiserum on experimental multiple system organ failure. Chin Med J (Engl) 1992; 105:833-8. [PMID: 1291201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This study examines the possible beneficial effect of Re-LPS (F515) antiserum on experimental multiple system organ failure (MSOF) in rabbits. The results showed that the plasma LPS level was significantly decreased, and it took a shorter period to clear up LPS in experimental than in control rabbits after receiving Re-LPS antiserum. Pretreatment with antiserum can markedly improve the function of the liver, lungs, kidneys, blood and gastrointestinal tract. The MSOF incidence in the group of rabbits receiving immune sera was only 11.2% and the survival rate was raised by about 40.0%. The results suggest that early passive immunotherapy may neutralize gut-derived endotoxin, inhibit endotoxin-induced mediators release and prevent development of severe complications due to sepsis. It is therefore postulated that LPS core antiserum may provide a prophylactic effect on the development of experimental MSOF.
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Affiliation(s)
- Y M Yao
- Trauma Research Center, Postgraduate Medical College, 304th PLA Hospital, Beijing
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27
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Abstract
Pulmonary oedema was produced in isolated lung lobes with steam and provided direct continuous measurements of transudation as it occurred. Transvascular flux (Qf) and weight gain (Gw) of the lobe increased immediately and the transudation reached its peak within half an hour after inhalation injury. Studies of protein content, colloid osmotic pressure of bronchial exudate and water content of lung, reconfirmed the increase in pulmonary capillary permeability. Marked haemoconcentration was revealed. Plasma leaked 113 g (25 per cent), plasma protein leaked 1.96 g (9.7 per cent) during the experiment. Based on the measured arterial pressure (Pa), vein pressure (Pv), arterial occlusion (Pao), venous occlusion (Pvo), double occlusion (Pdo) and blood flow through the lobe (Qt), the total vascular (Rt), arterial (Ra), middle compartment (Rmid) and venous (Rv) resistances were calculated. All the resistances were increased and the Qt showed a decrease after inhalation injury.
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Affiliation(s)
- Z R Guo
- Trauma Centre, 304th Hospital, Beijing, China
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28
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Sheng ZY, Dong YL, Wang XH. Bacterial translocation and multiple system organ failure in bowel ischemia and reperfusion. Chin Med J (Engl) 1991; 104:897-903. [PMID: 1800029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Portal circulation was reduced to 50-60% for one hour by partial occlusion of the superior mesenteric artery for the purpose of studying the relationship between reperfusion injury, bacterial translocation and multiple system organ failure. Forty dogs were divided randomly into four groups, and 1 x 10(10)/kg E. coli O111B4 were fed to each animal 12 hours before operation. Group I constituted the controls, in which sham operations were performed. The experimental procedure was completed in all the animals of the other three groups. Rubia yunnanensis, an anti-oxidant, was given to group III. Amikacin was given to group IV. The results showed that group II was characterized by bacteremia, hypoxemia, and hypotension as compared with group I. The levels of superoxide dismutase (SOD) in the whole blood were markedly lowered and malondialdehyde (MDA) values significantly elevated in group II after reperfusion compared with group I. Plasma levels of anaphylatoxin C5a and B2 (TXB2) were significantly raised in group II beginning with the reperfusion when compared with groups I, III and IV. Pathological changes in the intestine, liver and lung were remarkable only in group II, including acute necrosis of the intestinal mucosa, granulocyte infiltration, hemorrhage and edema of the lung, degenerative changes of myocardial and hepatic cells, and bacterial invasion of the blood, liver and lung. These results suggested that bowel ischemia and reperfusion may promote gut barrier failure and bacterial translocation, then contribute to the development to multiple system organ failure (MSOF) by allowing bacteria or endotoxin normally contained within the gut to reach the portal and systemic circulations where it fuels the septic process. Oxygen free radicals, anaphylatoxin and thromboxane may be potential factors in the development of gut barrier failure and MSOF.
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Affiliation(s)
- Z Y Sheng
- Trauma Center, Postgraduate Medical College, Beijing
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29
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Fang CH, Sun YH, Zhu ZM, Sheng ZY. The first symposium on burn shock. Chin Med J (Engl) 1991; 104:782-8. [PMID: 1935362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- C H Fang
- Department of Burn Surgery, First Hospital, Beijing Medical University
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30
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Sheng ZY, Guo ZR. Burn management and research in China. Chin Med J (Engl) 1991; 104:619-25. [PMID: 1914630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Z Y Sheng
- Trauma Center, Postgraduate Medical College, 304th Hospital, PLA, Beijing
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31
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Fu XB, Tian HM, Sheng ZY, Liu YQ. Special spectacles facilitating debridement. Report of use in 300 cases. Chin Med J (Engl) 1991; 104:693-6. [PMID: 1914637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
According to the difference of light reflection of tissue with different degree of viability, spectacles were made from glass permitting light of certain wavelength to pass to help distinguish viable from nonviable tissue. They were used in debridement of wounds in 300 patients. The results showed that the quality of debridement was improved as evidenced by better healing and shorter healing time. These spectacles were helpful, especially for young and unexperienced operators to distinguish viable from nonviable tissue. They were also used to predict flap viability in plastic surgery.
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Affiliation(s)
- X B Fu
- Trauma Center of Postgraduate Medical College, 304th Hospital, Beijing
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32
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Guo ZR, Sheng ZY, Wang DW, Zhu ZM, Li CG, Gao WY, Lin HY, Dong YL, Jia XM, Liu PT. The use of blood in burn shock. Clinical and experimental study. J Burn Care Rehabil 1989; 10:226-40. [PMID: 2473076 DOI: 10.1097/00004630-198905000-00008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We have given whole blood as one of the main constituents of burn shock resuscitation for the past 28 years. To appraise the value of using whole blood, we have summarized the clinical experience of 2630 burn patients. Overall mortality was 4.18%. The lethal area of the burn were 50% of the population is expected to die was 82.8% total body surface area and 57.4% third-degree burns. The incidence of renal failure, pulmonary edema, and gastrointestinal bleeding was 0.9%, 0.4%, and 0.6% respectively. To confirm the advantage of transfusion of whole blood, we have carried out a series of experimental studies. Two groups of 25 dogs with 25% total body surface area full-thickness burns were treated with two resuscitation regimens. Group I was treated with whole blood, and group II with no blood, during the shock phase. After 48 hours, the infusions were stopped. Measurements were made before the burn and 2, 24, 48, 72, and 144 hours after the burn injury. The animals were then killed for histologic studies. From our data, we concluded that whole blood used in burn shock did not increase hemoconcentration or viscosity; it improved anemia, oncotic pressure, hypoproteinemia, acid-base balance, oxygenation, hemodynamics, and myocardial contractility, promoted cardionatrin secretion, reduced edema of tissue, and protected viscera from degenerative changes and bacterial colonization.
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Affiliation(s)
- Z R Guo
- Trauma Centre, Postgraduate Medical College 304th Hospital of PLA, Beijing, China
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33
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Abstract
The aim of this study was to develop a porous silastic tube with filmy wall acting as permanent artificial tendon. Twelve mongrel dogs were used. Peronaeus longus and tibialis anticus were exposed, divided in two places, and sutured in situ; they were then covered by the silastic tube. A dog was sacrificed after 1, 2, 4, 6, 8, 10, 12, 16, 20, 24, and 44 weeks; specimens were removed. Each preparation was studied as follows: (i) gross observation and light microscopy for tendon preparations and (ii) transmission electron microscopy, scanning electron microscopy and phase microscopy for the pseudosheath. Our study showed that healing of the tendon was mainly an extrinsic mechanism and that the pseudosheath formed by the silastic tube can prevent the adhesion of the surrounding tissue; it follows that the use of an artificial tendon, including a tendon-graft coated with a silastic tube, in reconstruction of the flexor digital tendon in the hand is a feasible procedure. The appropriate porous diameter and porous distance should be studied further. Tendon gliding depends mainly upon the gliding plane between the composite body of the tendon and the loose connective tissue around it.
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Affiliation(s)
- D Y Dong
- Trauma Centre, Postgraduate College of PLA, Beijing, China
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34
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Sheng ZY, Lai YF, Wang HB, Zhao Y. Changes in erythrocyte membranes in burned rabbits. Burns 1988; 14:287-91. [PMID: 2852050 DOI: 10.1016/0305-4179(88)90068-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Eighteen white rabbits were subjected to a 30 per cent TBSA full thickness burn. Wound infection was found 9-13 days after injury and became severe a week or so later. ATPase activities, antioxidation ability, the proteins of erythrocyte membranes, and the Na+ contents of erythrocytes and serum were determined. The Ca++-ATPase activity was elevated during the first 17 days postburn, but showed a decline at the time of severe wound infection; the Na+,K+-ATPase activity showed peaks on postburn days 2 and 6, and then fluctuated above the preburn level. The change in Mg++-ATPase activity was similar to Na+,K+-ATPase. The erythrocyte Na+ content was increased, and the level of serum Na+ was decreased up to postburn day 6. Subsequently the erythrocyte Na+ was reduced and the serum Na+ increased up to day 17 postburn. The percentage of erythrocyte haemolysis in H2O2 was increased after the burn and became markedly so during wound infection, indicating that the antioxidation ability of burned rabbit erythrocytes was markedly impaired. During the period of wound infection, Coomassie blue-stained protein bands in SDS-polyacrylamide gel showed some changes in size and proportion in burned rabbits. For example, the second band was wider, the band 2 to band 1 ratio increased, and band 5 was smaller than before injury. These results seem to show that burn injury, especially when associated with sepsis, may affect both the structure and function of biological membranes.
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Affiliation(s)
- Z Y Sheng
- Trauma Center, Postgraduate Medical College, PLA Beijing, People's Republic of China
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35
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Sheng ZY. [Protective effects of anti-oxidants in hepatic and pulmonary injuries subsequent to bowel ischemia]. Zhonghua Yi Xue Za Zhi 1988; 68:183-6, 14. [PMID: 3196932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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36
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Sheng ZY. Medical support in the Tangshan earthquake: a review of the management of mass casualties and certain major injuries. J Trauma 1987; 27:1130-5. [PMID: 3312621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Tangshan earthquake was probably the worst catastrophe in this century. It took a death toll of 242,769, with 164,851 injured in addition. This presentation describes the organization of disaster relief work after the earthquake, the rescue of buried victims, the organization of medical resources, and the sanitation work to forestall epidemics. It also presents the author's reflections on the management of three major injuries, namely, crush syndrome, fracture of pelvis, and traumatic paraplegia, by reviewing the available data pertaining to these injuries. The author concurs with the prevailing opinion that fasciotomy plays an important role in the successful management of crush injury. It not only prevented acute renal failure subsequent to intracompartmental increase of pressure, but also the occurrence of Volkmann's ischemic contracture as a late sequela. Herbs to induce catharsis and diuresis were used to alleviate intracompartmental pressure. For the management of pelvic fractures, two newly developed treatment techniques are described. On analysis of clinical data, it is the author's opinion that traumatic paraplegia should not be given the priority of early surgery in the circumstances of mass casualties. The primary concern should be the stability and restoration of normal curvature of the spine, especially in cases of complete paraplegia. Decompression of the spinal cord through an anterolateral approach gave promising results in hyperflexion type of spinal fracture.
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Affiliation(s)
- Z Y Sheng
- Trauma Center, Postgraduate Medical College of PLA, 304th Hospital of PLA, Beijing, People's Republic of China
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Sheng ZY, Tung YL. Neutrophil chemiluminescence in burned patients. J Trauma 1987; 27:587-95. [PMID: 3599105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Phagocytic and bactericidal assays showed that a close correlation was present between bactericidal activity and neutrophil chemiluminescence (PMN-CL) (r = 0.81; p less than 0.01). This suggested that the microbicidal action of the neutrophil depends metabolically on the generation of oxygenating agents. PMN-CL and opsonic index (OI) were measured in 36 burned patients. The levels of serum transferrin (Tf) were examined simultaneously by nephelometric method in order to determine the correlation between humoral-phagocyte axis of immune system and nutritional status. It was found that PMN-CL and OI were generally lower in the greater than 35% TBSA burn group (PMN-CL, 1.85 +/- 0.21 cpm X 10(3), OI, 0.69 +/- 0.06) compared with control subjects (PMN-CL, 3.55 +/- 0.15 cpm X 10(3), OI, 1.05 +/- 0.04). It suggested that both neutrophil oxygenation activity and opsonic activity were impaired following severe burns. PMN-CL was higher in the smaller than 30% TBSA burn group during infection phase as compared with control subjects (5.61 +/- 0.26 cpm X 10(3) vs. 3.55 +/- 01.5 cpm X 10(3); p less than 0.01). It remained high in patients with persistent infection, but fell to normal if appropriate therapy was instituted. This result indicated that the neutrophils of the majority of patients with minor burns during acute infection were in an activated state both metabolically and functionally. The occurrence of sepsis was associated with a marked lowering of PMN-CL and OI values, but no difference was noted before and after the development of sepsis. The incidence of sepsis was 85.7% when PMN-CL was lower than 2 cpm X 10(3).(ABSTRACT TRUNCATED AT 250 WORDS)
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Abstract
Plasma fibronectin was determined in 180 healthy individuals. No significant difference was found between males and females: therefore the values were pooled. The mean value was 286.94 +/- 51.35 micrograms/ml. In 24 patients with burns covering 30-95 per cent of the total body surface area (TBSA), plasma fibronectin was determined sequentially. There was a significant lowering in plasma fibronectin (FN) values in all cases on post-burn day 1 (112.56-185.85 micrograms/ml) and post-burn day 2 (44.03-298.0 micrograms/ml). The concentrations returned to within the normal range in 19 survivors within 3-6 days. In five non-survivors, plasma FN levels fell progressively until death. In another nine patients with burns ranging from 3 per cent to 25 per cent TBSA, plasma FN level was found to be normal on post-burn day 1. The likely causes of the reduced concentrations of plasma fibronectin in patients with burn injuries are briefly discussed. It seems that the level of plasma fibronectin may be used as a prognostic index in burn patients.
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Dong YL, Sheng ZY, Zhang ZY. [Delayed hypersensitivity and levels of serum transferrin in burn patients and their clinical significance]. Zhonghua Wai Ke Za Zhi 1986; 24:419-21, 446-7. [PMID: 3816456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Guo ZR, Sheng ZY. [The application of plastic splints in burns and reconstruction surgery]. Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi 1985; 1:45-6. [PMID: 3939794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Sheng ZY. [Dynamic changes in serum osmolarity and colloidal osmotic pressure in burn patients]. Zhonghua Wai Ke Za Zhi 1984; 22:468-71, 510. [PMID: 6518906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Liu SH, Sheng ZY. Contraindications to early escharectomy in major burn. Chin Med J (Engl) 1983; 96:783-6. [PMID: 6426876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Zhu ZM, Sheng ZY. [Storage of the skin in liquid nitrogen and its experimental use]. Zhonghua Yi Xue Za Zhi 1982; 62:559-60. [PMID: 6816449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Sheng ZY. [Management of combined thermal and mechanical injuries (author's transl)]. Zhonghua Wai Ke Za Zhi 1981; 19:607-9. [PMID: 7341126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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