Biomedical subjects

J Chai

Publications and source records attributed to J Chai.

At least 55 records · Page 3Linked to original sources

PubMed2000

[Anisodamine in prevention and treatment of sepsis of severely burned patients].

OBJECTIVE: To observe the preventive effect of anisodamine on possible sepsis of patients with major burns and the effect of anisodamine on patients with sepsis. METHODS: Forty-two patients with extensive burn admitted to our burn institute from April 1998 to November 1999 were divided randomly into two groups: treatment group (T group) and control group (C group). In the T group, all 20 patients received fluid resuscitation regimen with anisodamine, and in the C group, 22 patients received the regimen with no anisodamine. A tonometry catheter was positioned in the stomach, connecting with the automatic gas analysis machine (Datex-Engstrom Corporation, Dutch) for determining gastric intramucosal pH (pHi). The plasma concentrations of diamine oxidase (DAO) and endotoxin were measured. Correlation analysis between pHi, DAO and endotoxin were made respectively during early stage of postburn. All the parameters in 7 patients with sepsis before and after administration of anisodamine were compared with those in 6 patients with sepsis without use of anisodamine. RESULTS: The incidence of sepsis in the T group was lower (20.0%) than that in C group (40.9%). The gastric pHi value in the early period of postburn was significantly higher in the T group than in the C group (P < 0.05). Concurrently, the plasma concentrations of DAO and endotoxin were significantly lower in the T group than in the C group (P < 0.05 or 0.01). A significant negative correlation was seen between the gastric pHi and respective values of DAO, endotoxin (P < 0.05 or 0.01). There were a decrease in gastric pHi, and an increase in plasma DAO and endotoxin level in patients with septic episode; however all the parameters after administration of anisodamine were improved compared with those in septic patients without use of anisodamine. CONCLUSIONS: Intestinal ischemic injury plays an important role in provoking sepsis during early postburn period. Anisodamine is effective in restoring intestinal circulation both in the shock phase and after the development of sepsis.

Adolescent↗

PubMed2000

[Clinical use of acellular allogenic dermis or acellular porcine dermis with split-thickness autologous skin graft in 119 cases].

OBJECTIVE: To observe the effect of acellular allogenic dermis or acellular porcine dermis together with split-thickness autologous skin graft on coverage of deep burn wound and the wound of scar excision. METHODS: Acellular allogenic dermis or acellular porcine dermis produced by our unit, with split-thickness autologous skin graft, were used in repairing various wounds in 119 cases. The take rate of various wounds was compared, and the take rate of wounds in which autologous skin from different sites was used to cover either acellular allogenic dermis or acellular porcine dermis was also compared. Histological examination and follow-up were made in some cases. RESULTS: After tangential excision, eschar excision and scar excision, the wounds were covered with either allogenic acellular dermis or porcine acellular dermis and autologous split-thickness skin. The take rate was found to be (93.4 +/- 3.4)%, (92.1 +/- 4.6)%, (94.5 +/- 3.5)%, respectively. There was no a significant difference in take rate (P > 0.05). No significant difference in take rate between the transplantation of allogenic acellular dermis with autologous split-thickness skin and transplantation of porcine acellular dermis with autologous split-thickness skin was found (P > 0.05). When autologous split-thickness skin harvested from the trunk or extremities was used, the take rate was (93.1 +/- 4.8)%, (89.0 +/- 6.2)%, respectively, whereas the take rate was only about 70% - 80% when skin harvested from the scalp was used. The take rate was only about 40% when acellular allogenic dermis and autologous micro-skin graft were used to cover the wound. Histological examination 19 months after the transplantation revealed normal structure. Collagenous fibers were orderly arranged. There was no apparent hyperplasia of collagenous fibers. Hair follicles, sweat glands and other skin appendages were not found in the healed area. Grossly, no obvious pigmentation was seen, the surface was smooth with slight wound contraction, and the consistency was flexible. CONCLUSION: Acellular allogenic split-thickness dermis or acellular porcine split-thickness dermis with autologous split-thickness dermis for coverage of deep burn wound and the wound of scar excision is an ideal material.

Adolescent↗

PubMed2000

[Effect of escharectomy and skin grafting of minipigs during burn shock stage on postburn energy expenditure].

OBJECTIVE: To determine the changes in resting energy expenditure (REE) of minipigs in normal and postburn stage, and the effect of escharectomy during burn shock stage on energy expenditure. METHODS: Swine model with 35% TBSA III degree flame burn was used. Eighteen male minipigs were randomly divided into three groups: control group, escharectomy during burn shock stage group and escharectomy after burn shock stage group. REEs were monitored by means of Cardiorespiratory Diagnostic Systems (Medical Graphics Corporation, USA). RESULTS: The levels of REE in escharectomy during burn shock stage group decreased early and were obviously lower than those in other two groups. CONCLUSION: These findings suggest that escharectomy and skin grafting during burn shock stage could ameliorate hypermetabolism in major burn patients.

Animals↗

PubMed2000

[The experience of the management of burn sepsis with different strategies in our department during the past 29 years].

OBJECTIVE: To retrospectively sum up the experiences in the prevention and treatment of sepsis after thermal injury. METHODS: From January 1970 through October 1998, altogether 5 330 burn patients were admitted to our burn center, and among them 451 patients developed sepsis. To analyze the efficacy of different treatment strategies developed during these 29 years, three periods were divided, namely 1970 to 1979, 1980 to 1992, and 1993 to 1998. The incidence and mortality of sepsis were compared, thereupon the efficacy of different treatment strategies were analyzed. RESULTS: The overall incidence and mortality of sepsis in all patients and those in patients with burn extent exceeding 30% TBSA were significantly lower in the latter period compared with the former two periods (P < 0.05 similar 0.01). In addition, in the last period, blood levels of LPS, TNFalpha, IL -- 6, and IL -- 8 were obviously higher throughout the course of MODS, especially before death, in the patients who finally died of sepsis, complicated by MODS, compared with those in the survivors (P < 0.05 similar 0.01). CONCLUSION: Summing up our experiences, it is our belief that the treatment strategies for prevention of postburn sepsis in extensively burned patients should include rapid, adequate fluid resuscitation for burn shock, effective control of infection, early excision of deep burnwounds followed by good skin coverage, and reinforcement of organ support. Once burn wound sepsis occurs, prompt removal of infected necrotic tissue is the key procedure to ensure a successful result.

Adult↗

PubMed2000

[A clinical study on PA-MSHA vaccine used for adjuvant therapy of lymphoma and lung cancer].

The objective of this study was to evaluate the effectiveness and safety of pseudomonas aeruginosa MSHA vaccine (PA-MSHA vaccine) used as an immune modulator. The study was carried out after the design of a non-blind, randomized controlled trial. The malignant lymphoma patients were divided into experiment group (45 cases) and control group (43 cases). Likewise were distributed the lung cancer patients: 44 cases in experiment group and 45 cases in control group. The two experiment groups received chemotherapy + PA-MSHA vaccine. The two control groups were given chemotherapy alone. The results showed that the clinical efficacy rate was 95.56% for the exp. group and 69.77% (P < 0.01) for the control group of the malignant lymphoma cases; the clinical efficacy rate was 59.09% for the exp. group and 42.22% (P < 0.01) for the control group of the lung cancer cases. The infection rate was 17.78% for the exp. group and 37.21% (P < 0.05) for the control group of the malignant lymphoma cases; the infection rate was 15.91% for the exp. group and 40.00% (P < 0.05) for the control group of the lung cancer cases. The comprehensive immune effectiveness rates for the exp. group and control group of the malignant lymphoma cases were 77.78% and 23.26% (P < 0.01) respectively. The comprehensive immune effectiveness rates for the exp. group and control group of the lung cancer cases were 84.09% and 35.56% (P < 0.01) respectively. Adverse reactions were found in 5 cases, of which, one was given medical care while the others automatically recovered. These results indicate that PA-MSHA vaccine, as a new kind of immune modulator, can improve the effectiveness of treatment for tumor with low adverse reaction rate.

Adjuvants, Immunologic↗

PubMed2000

[A simplified six-item checklist for screening of fragile X syndrome].

OBJECTIVE: To investigate whether a simplified six-item checklist could be developed to improve the screening fragile X syndrome test result. METHODS: Nine clinical characteristics were selected from patient records of 190 male and 18 female pediatrics for fragile X screening test were analyzed. The characteristics included mental retardation, family history of mental retardation, elongated face, large or prominent ears, attention deficit hyperactivity disorder, Autistic-like behavior, simian crease, macroorchidism, and hyperextensible joints. RESULTS: Seven cases were diagnosed with fragile X syndrome by Southern analysis on PCR product. Among the nine characteristics, simian crease, macroorchidism, and hyperextensible joints were eliminated, because of low frequency and statistical insignificance. Using remaining six-item clinical checklist, if a score of 6 or more was used as the criteria for screening fragile X test, about 60% of this test in our cases could have been eliminated clinically without missing any positive cases. Thereby the proportion of case with positive results improved 8.8%. CONCLUSIONS: With our simplified six-item clinical checklist, 60% of testing could have been eliminated clinically, thereby improving the effectiveness of fragile X screening test and promoting the proportion of cases with positive results in two groups.

Adolescent↗

PubMed1999

[Experimental study on the mechanisms of enhancement of aerobic glycolysis of muscles in burns and sepsis--the verification of the existence and the enhancement of the aerobic glycolysis of muscles in early postburn period and sepsis].

OBJECTIVE: To verify if aerobic glycolysis exists in the muscle cells in normal rats and to analyze the changes in aerobic glycolysis in the muscle cells in the early postburn period and in septic states. METHOD: Using septic model of rats, we established the in vitro muscle incubation system with sufficient oxygen supply as well as the NADH fluoremetric method for the detection of trace amount of lactate in the samples. Extensor digitorium longus (EDL) and soleus muscles which represent two types of muscle fiber were studied. RESULTS: In the early postburn period as well as in septic states, the lactate production of muscle cells was significantly elevated as compared to the normal controls even though the muscles were incubated in a fully oxygenated media. The levels of aerobic glyoclysis, as well as its changes in postburn period and in septic states, vary depending on the difference in the fiber composition of the muscles. CONCLUSION: Muscle cells might develop a kind of metabolic enhancement which is referred to as aerobic glycolysis rather than the metabolic defect which results from tissue hypoperfusion and hypoxia in the early postburn period as well as in septic states. This provides us a special insight to elucidate the mechanisms of the metabolic derangement in the early postburn period and in sepsis.

Animals↗

PubMed1999

[Analysis of factors influencing healing time of burn wounds].

OBJECTIVE: To analyze the factors influencing healing time, length of hospital stay and hospital costs in burn patients. METHODS: Seven hundred and ninety-one burn patients with principal component analysis were studied retrospectively. RESULTS: There were some factors that influence healing time, including total area of burn, the area of full-thickness burn, the area of partial-thickness burn, inhalation injury, sepsis, shock, visceral complication, combined injuries, the size of surgical excision, the time of surgical excision, whether or not excision of burn wound was done in shock stage, and use of antibiotic, etc. Further analysis indicated that the patients undergo escharectomy during shock stage had better recovery with lower incidence of visceral complications and sepsis, especially in those with major burn over 30 percent TBSA. CONCLUSION: To reduce healing time of burn patients, there are many effective methods such as the prevention and treatment of shock, sepsis, visceral complication, and appropriate use of antibiotics. The most important factor to reduce healing time of burn patients is escharectomy as early as possible for major burns.

Adult↗

PubMed1999

[Hemodynamic monitoring in 52 serious burn patients in ten years].

OBJECTIVE: To determine the benefit of hemodynamic monitoring for resuscitation of burn shock. METHODS: A group of 52 burned patients with mean burn area of (69.9 +/- 20.1)% TBSA burn injury (range 31%-100%), and mean III burn area of (60.4 +/- 13.6)% TBSA were included in this study. Swan-Ganz catheters were inserted to monitor hemodynamics including RAP, PAP, PAWP, HR, CO, CI, and SI, etc. after admission at 8, 16, 24, 36, 48, 72, and 96 hours postburn. RESULTS: It was reasonably safe to perform invasive monitoring during early resuscitation. With the guide of hemodynamic monitoring, evidence of global hypovolemia disappeared at 24 hours after burn injury with appropriate resuscitation therapy. CONCLUSION: Invasive hemodynamic monitoring may be necessary to optimize resuscitation of serious burn patients with reasonable safety.

Adolescent↗

PubMed1999

[Performing escharectomy following "clinical guidelines" in extensively burned patients during burn shock stage].

OBJECTIVE: To verify the practicability of performing escharectomy on extensively burned patients during shock stage following the clinical guidelines only. METHOD: Sixty-five burn patients with total body surface area(TBSA) over 30% received resuscitation to prevent and treat burn shock without hemodynamic monitoring. Clinical indexes of optimal resuscitation, such as a urine volume 80 to 100 ml/h, heart rate around 100 to 110/min, respiration rate 20 to 24/min, significant alleviation of thirst, sense of nausea and vomiting, clear mentality, Hb < or = 150 g/l and Hct < or = 0.50 were adopted as guidelines, under which thirty-three patients underwent escharectomy and grafting during burn shock stage (group A). For comparison, other 32 patients received escharectomy 96 hr after injury(group B). The incidences of sepsis and MODS were analyzed. Plasma samples from 12 patients in group A and 9 patients in group B were assayed at interval for LPS, TNF, IL-6 and IL-8. RESULTS: All 33 patients in group A were in stable condition, and the incidence of sepsis was lower (34.4%) than that in group B(56.3%). The incidence of MODS and the mortality of patients in group A was lower than those in group B. Levels of LPS, TNF, IL-6 and IL-8 in plasma were lower in group A as compared with those in group B. CONCLUSION: The results show that escharectomy could be performed during shock stage under clinical guidelines with reasonable safety.

Adolescent↗

PubMed1999

[Impact of intracellular Na+ concentration alteration on intracellular aerobic glycolysis in skeletal muscles in sepsis].

OBJECTIVE: To evaluate the impact of the changes of the intracellular Na+ concentration on the cellular lactate production of different skeletal muscles in septic rats as compared to that of the normal ones. METHODS: Using septic model of rats, we established the in vitro muscle incubation system with sufficient oxygen supply as well as the NADH fluoremetric method for the detection of trace amount of lactate in the samples. By using the specific Na+ ionorphor--monensin, the distribution of transmembrane Na+ was under control and the lactate production of the muscle cells were measured. RESULTS: The intracellular glycolysis was activated by increasing of intracellular Na+ probably because of the mechanism of Na+ pump activation. The sensitivity of muscles to monensin varied according to different muscle fiber composition. The mechanism of the aerobic glycolysis activation in sepsis was identical to the roles of monensin in the cells. CONCLUSION: The increase of the permeability of Na+ in skeletal muscle cells as well as the increment of the intracellular concentration of Na+ can directly lead to the enhancement of muscular aerobic glycolysis and its mechanism plays a significant role in the enhancement of muscular glycolysis in septic states.

Animals↗

PubMed1999

[The effects of escharectomy during burn shock stage on metabolic rate alterations].

OBJECTIVE: To determine whether early massive eschar excision and skin grafting may decrease the hypermetabolic response that characterizes burn injury. METHOD: Twenty-one adult men with burns over 30% of the total body surface area were assigned to one of two treatment groups. Resting energy expenditures (REEs) were obtained by means of cardiorespiratory diagnostic systems (made by Medical Graphics Corporation in USA) at the patients' bedsides. RESULTS: The clinical conditions and non-operative management in two groups were comparable [(311 +/- 15) J.h-1.m-2 vs (345 +/- 16) J.h-1.m-2], but different in time of eschar excision and skin grafting. Although REEs increased sharply in all patients, the patients in group 1 with escharectomy during burn shock stage had lower REEs than those in group 2 with escharectomy after burn shock stage. CONCLUSION: Escharectomy during burn shock stage contribute to decreasing the hypermetabolic response to burn injury.

Adult↗

PubMed1999

[Treatment of invasive burn wound infection with sepsis: a clinical study].

OBJECTIVE: To further improve the treatment of burn wound sepsis. METHODS: Eight patients with burn wound sepsis, of whom 6 with MODS and two with septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentrations of IL-6, IL-8 TNF and LPS were assayed before and after surgical intervention and at the time when the patients' vital signs became stable. RESULTS: (1) The patients' conditions abruptly deteriorated when the burn wound sepsis emerged. (2) The major causative factor related to burn wound sepsis was extensive burn injuries, with large area of deep burn remained open. (3) Although colonization by multiple pathogenic bacteria was found, Pseudomonas aeruginosa was the most frequent bacteria isolated from the subeschar tissue. (4) The plasma concentrations of IL-6, IL-8, TNF and LPS before surgical intervention were significantly higher than those after surgical intervention (P < 0.05); (5) The lowest level of the inflammatory mediators were observed when the conditions of patients became stable, and the values were significantly lower compared with those before surgical intervention (P < 0.001). CONCLUSIONS: The main cause of burn wound sepsis is the presence of a large area of infected open deep burn wounds, which should be excised and covered early. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn wound sepsis. Favorable results in the treatment attribute to appropriate application of multiple treatments, and early, aggressive and thorough surgical excision of invasive burn infectious tissue and closure of wounds play a crucial role.

Adolescent↗

PubMed1999

[Effect of escharectomy during burn shock stage on stress response].

OBJECTIVE: To investigate changes in hormones of plasma and the effect of escharectomy during burn shock stage on early stress response after burn. METHODS: Sixteen male minipigs were subjected to a 35% TBSA III degree burn injury. The burned minipigs were randomly divided into two groups: escharectomy during burn shock stage group (S group) and escharectomy group after burn shock stage (N group). The sequential changes in plasma levels of insulin, glucagon, cortisol, GH, IGF-I, albumin were analyzed. RESULTS: The serum concentration of insulin, glucagon, cortisol increased to some degree, whereas the serum concentration of GH, IGF-I decreased obviously after burn. As compared with the N group, no significant difference in the serum concentration of glucagon, cortisol, GH, IGF-I, was observed. CONCLUSIONS: Escharectomy during burn shock stage could not aggravate stress response after burn.

Animals↗

PubMed1999

[The effect of early escheractomy on expression of ICAM-1 and E-selectin mRNA of endothelial cells].

OBJECTIVES: To examine the effect of burned serum on change in endothelial cell ICAM-1 and E-selectin mRNA expression and whether these alterations can be corrected by the means of escharectomy during burn shock period. METHODS: One hundred and seventy-six Wistar rats with 30% III degree TBSA on back were studied. Endothelial cell ICAM-1 and E-selectin mRNA were tested with the method of RT-PCR. RESULTS: ICAM-1 and E-selectin expression showed an increase after stimulation by serum of 4 hours post burn, reaching peak levels 168 hours after injury. ICAM-1 and E-selectin expression levels could decrease to baseline within 168 hours in the rats which underwent escharectomy during shock stage, but kept higher than normal in rats without escharectomy or underwent 96 hours post burn. CONCLUSIONS: These findings suggest that eschar can induce endothelial cells to express adhesion molecule. Early escharectomy is important to prevent adhesion molecule expression and SIRS.

Animals↗

PubMed1999

[The application of chopping method for phacoemulsification of hard nucleus cataract].

OBJECTIVE: The study was designed to investigate the application of chopping method for phacoemulsification of hard nucleus cataract. METHODS: Modified stop and chop technique was used to emulsify the hard nucleus cataract. The degree of nuclear hardness in 80 eyes was grade IV. RESULTS: Postoperatively, the visual acuity with correction was >or= 0.9 in 76.25% at 3 months. There were mild corneal edema in 8 cases, moderate corneal edema in 2 cases and posterior capsular rupture in 1 case. CONCLUSION: The modified stop and chop technique enables the tenacious nuclear plate to rupture easily, thus the stress on the zonules and capsule can be decreased, and in the mean time the technique needs less phaco energy and time.

Aged↗

PubMed1999

[Protective effects of leishmanial antigens against Leishmania infantum infection in Lagurus lagurus].

AIM: To determine the protective effect of leishmanial surface antigens against experimental visceral leishmaniasis in Lagurus lagurus caused by Leishmania infantum. METHODS: Recombinant surface protein (rGP63) and lipophosphoglycan (LPG) of Leishmania were used with Corinebacterium parum vaccine as ajuvant to immunize Lagurus lagurus against a challenge with virulent strain of Leishmania infantum. The efficacy of immunoprotection was observed. RESULTS: When challenged with up to 2 x 10(7) promastigotes, the number of LD on the liver printing sections in the rGP63 + LPG + CP immunised animals was significantly decreased, the parasite reduction rate being 89.79%. LPG + CP gave a parasite reduction rate of 60.6% and rGP63/beta-galactosidase fusion protein + CP showed a parasite reduction rate of 42.45%. Purified rGP63 showed no protection. Immunization with rGP63 + LPG + CP followed by challenge inifection with 1 x 10(6), 5 x 10(6) and 1 x 10(7) promastigotes also showed significantly reduced infection rates. CONCLUSION: A combination of rGP63 + LPG + CP antigens could provide significant immunoprotection against L. infantum challenge in L. lagurus.

Animals↗

PubMed1999

[Expression of nm23-H1 gene in oral squamous cell carcinoma and its relation to tumor metastasis].

OBJECTIVE: To make an inquiry into the relation between the expression level of nm23-H1 protein and metastasis of oral squamous cell carcinoma (OSCC). METHODS: We evaluated the expression of nm23-H1 protein in 75 cases of OSCC by immunohistochemical technique (SABC). RESULTS: These immunoreactivities of nm23-H1 protein were most common in the cytoplasm of tumor and epithelia cell. Using single-factor chi-test, we found there was a significant correlation between the expression of nm23-H1 protein and lymph node metastasis of OSCC (P < 0.01), pathology grade (P < 0.05). But no statistical association was found among nm23-H1 protein expression level and tumor size, site and patient's sex, age. Using multi-factor logistic stepwise regression analysis, we found that nm23-H1 protein expression level had more effect on OSCC cervical lymph node metastasis than any other parameters. CONCLUSIONS: The results suggested that nm23-H1 protein play an important role in the suppression of the metastasis of OSCC, and that determining the expression level of nm23-H1 protein may help us prognose the metastasis of OSCC.

Adult↗