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Biomedical subjects

Z Sheng

Publications and source records attributed to Z Sheng.

At least 37 records · Page 2Linked to original sources
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

[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

[The significance of the expression of the HSP70 and HSP90 in the intestinal mucosa in scalded rats during early postburn stage].

OBJECTIVE: To investigate the changes in the expression, the tissue contents and the distribution of heat shock protein (HSP) 70 and HSP90 in the intestinal mucosa in scalded rats during early postburn stage and to elucidate the effects of heat shock response of intestinal mucosal cell on burn victim's systemic pathophysiology. METHODS: The scalded rats were taken as the model. ELISA, immunoblotting analysis and immunohistochemical methods were employed to analyze and study the expression, the tissue contents and the distribution and their functional status of HSP70 and HSP90 in the intestinal mucosa. RESULTS: (1) The free HSP70 content in the intestinal mucosa exhibited significantly transient decrease in the early postburn stage. (2) The total contents of HSP70 and HSP90 in the intestinal mucosa increased obviously postburn. (3) There exhibited remarkable heterogeneity of the molecular structure of HSP70 in the intestinal mucosa in the early postburn stage. CONCLUSION: The expression and the changes in the contents and the tissue distribution of the two HSPs in the intestinal mucosal cell might play important roles in the cellular stress reaction of the intestinal mucosa and even in the intestinal barrier functional mechanism.

Animals↗
PubMed2000

[Hemostatic variations associated with acute leukemia: clinical and prognostic significance].

OBJECTIVE: To study the hemostatic abnormalities and their association with bleeding manifestation and prognosis in acute leukemia (AL) patients. METHODS: A series of hemostatic parameters were determined in 93 cases of AL using ELISA or chromogenic assay. RESULTS: At diagnosis, plasma levels of P-selectin, soluble fibrinomonomer complex (SFMC), thrombomodulin (TM), tissue plasminogen activator, D-dimer (D-D) were significantly elevated, but protein C antigen (PC:Ag), plasminogen (PLG), alpha(2)-antiplasmin (alpha(2)-PI) and plasminogen activator inhibitor (PAI) were decreased, and fibrinogen (Fg), PC activity (PC:A) and protein S (PS) were in normal range. All the above abnormalities returned to normal after complete remission (CR) except for PC:A and PC:Ag. Platelet counts, Fg, SFMC, PLG, alpha(2)-PI and D-D were significantly associated with hemorrhagic manifestations. TM, PS and PAI were related to prognosis. CONCLUSION: There existed the consumption of platelets as well as the activation of coagulant, anticoagulant and fibrinolytic systems in AL, which was greatly improved after CR.

Acute Disease↗
PubMed1999

Hair cell protection from aminoglycoside ototoxicity by adenovirus-mediated overexpression of glial cell line-derived neurotrophic factor.

Aminoglycosides are commonly used antimicrobial drugs that often have ototoxic side effects. The ototoxicity often involves permanent loss of cochlear hair cells (HCs). Neurotrophic factors have been shown to protect a variety of tissues, including HCs, from toxic trauma. To determine if glial cell line-derived neurotrophic factor (GDNF) can protect cochlear HCs from trauma, we inoculated an adenoviral vector encoding the human GDNF gene into guinea pig cochleae via the round window membrane 4 days prior to injection of aminoglycosides. Control groups showed little or no negative influence of the viral inoculation on cochlear structure and function. In contrast, ears that were inoculated with the GDNF vector had better hearing and fewer missing HCs after exposure to the ototoxins, as compared with controls. Our results demonstrate the feasibility of gene therapy for cochlear application and suggest that virus-mediated overexpression of GDNF may be developed as a valuable prevention against trauma-induced HC death.

Adenoviridae↗
PubMed1999

Assessment of genetic changes in hepatocellular carcinoma by comparative genomic hybridization analysis: relationship to disease stage, tumor size, and cirrhosis.

Hepatocellular carcinoma (HCC) is a common and highly malignant tumor that is prevalent in Southeast Asia. Although the etiological factors associated are now well recognized, the interactions between individual factors and the molecular mechanisms by which they lead to cancer remain unclear. Cytogenetic analysis on HCC has been limited because of poor hepatocyte growth in vitro. The recently developed technique of comparative genomic hybridization (CGH), however, permits screening of the entire genome without the need of cell culture. CGH was applied to the study of genomic aberrations in 67 surgically resected samples of HCC, 3 of adenomatous hyperplasia (AH), and 12 of nontumorous cirrhotic liver surrounding the tumors. All samples were from patients of a racially and etiologically homogeneous population in Southern China, where chronic hepatitis B virus infection is the main etiological factor. CGH analysis of the HCC samples revealed frequent copy number gain of 1q (48/67 cases, 72%), 8q (32/67 cases, 48%), 17q (20/67 cases, 30%), and 20q (25/67 cases, 37%) and common losses on 4q (29/67 cases, 43%), 8p (25/67 cases, 37%), 13q (25/67 cases, 37%), and 16q (20/67 cases, 30%). Our finding of a high incidence of 1q gain strongly suggested this aberration was associated with the development of HCC. Genomic abnormalities were detected in 1 of the 3 AH specimens but absent in all 12 cirrhotic tissues surrounding the tumor. Clinical staging classified 3/67 HCC cases as T1, 53 cases as T2, and 11 cases as T3. No significant difference in the pattern of genomic imbalances was detected between stages T2 and T3. A significant copy number loss of 4q11-q23 was, however, identified in those tumors larger than 3 cm in diameter. Of particular interest was the identification of 8q copy number gain in all 12 cases of HCC that arose in a noncirrhotic liver, compared with only 20/55 cases in HCC arising in a cirrhotic liver. We suggest that 8q over-representation is likely associated with a growth advantage and proliferative stimulation that have encouraged malignant changes in the noncirrhotic human liver.

Adult↗
PubMed1999

Recombinant fusion protein and DNA vaccines against foot and mouth disease virus infection in guinea pig and swine.

In this study, we provide evidence that a recombinant fusion protein containing beta-galactosidase and a tandem repeat peptide of immunogenic dominant epitope of foot-and-mouth disease virus (FMDV) VP1 protein elicits high levels of neutralizing antibody and protects both guinea pigs and swine against infection. Vaccination with this fusion protein induced a FMDV-specific proliferative T-cell response and a neutralizing antibody response. The immunized guinea pigs and swine were protected against FMD type O virus infection. Two DNA plasmids expressing genes of foot-and-mouth disease were constructed. Both plasmids pBO1 and pCO1 contain a signal sequence of the swine immunoglobulin G (IgG) gene and fusion protein gene of pXZ84. The signal sequence and fusion protein gene were under the control of a metallothionein promoter in the case of the pBO1 plasmid and under the control of a cytomegalovirus immediate early promoter in the case of pCO1 plasmid. When pBO1 and pCO1 were inoculated intramuscularly into guinea pigs, both plasmids elicited a neutralizing antibody response and spleen cell proliferation increased following stimulation with FMDV antigen, but animals were not protected from viral challenge.

Animals↗
PubMed1999

Human T-cell lymphotropic virus types I and II infections in mother-child pairs in Nigeria.

A community-based survey to determine the prevalence of human T-cell lymphotropic type I (HTLV-I) and type II (HTLV-II) virus infections in mothers and children in south-western Nigeria was carried out using blood samples collected in 1993. A multistage cluster, random sampling procedure was used to select 460 mother-child pairs (476 children because there were 16 sets of twins) from 14 enumeration areas. A commercially available, whole HTLV-I lysate antigen-based ELISA method was used to screen for HTLV-I and HTLV-II antibodies in the samples. A synthetic peptide antigen-based ELISA was then used to differentiate between antibody reactivity to either HTLV-I or HTLV-II. Reactivity to HTLV-I or HTLV-II antibodies was found in 4.3 per cent (20/460) of mothers and in 1.1 per cent (5/476) of children in both rural and urban communities and all the positive children were males. None of the 16 sets of twins in this study was positive for either HTLV-I or HTLV-II. Also none of the mother-child paired sera tested showed concordance for either HTLV-I or HTLV-II antibody positivity. The lack of concordance between mother and child sera suggests that vertical transmission may not be the major route of transmission of HTLV infection to children in south-western Nigeria. Other modes of transmission, such as the re-use of unsterilized needles for injections and surgical knives in local scarification, which are common practices in the region, need to be investigated as they may prove to be more important than vertical transmission. These findings have important implications for any control programme for diseases that can be spread by the same routes as HTLV infection (the human immunodeficiency viruses, hepatitis B, and hepatitis C infections).

Adult↗
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

[Role of endothelin and nitric oxide in early gut ischemia].

OBJECTIVE: Inadequate perfusion in splanchnic organs and especially in the gut during acute burn period has been reported in many conventionally "successfully" resuscitated patients, but the mechanisms still remain unclear and its early preventive measures need to be further studied. The aim of this study is to evaluate the role of endothelin and nitric oxide in gut ischemia. METHODS: Eighteen male pigs were randomly assigned to one of the three groups: group C, a sham burn group that was subjected to all surgical procedures except burn; group B, sustained 30% TBSA cutaneous thermal burn; Group N, NO donor (C87-3754) was given intravenously (0.0125 mg.kg-1.min-1) at the beginning of resuscitation. RESULTS: In group B, PVF decreased rapidly after burn, and did not recover in the observation period (72 h), ET levels in portal blood and intestinal tissue elevated contrary to the changes in NO. In group N, PVF was higher than in group B. CONCLUSION: 1. Changes in ET and NO may influence the protal blood flow. 2. NO donor was proved to be beneficial in improving GI tissue perfusion by releasing NO.

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

[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

[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

[Biopterin synthesis and GTP cyclohydrolase I mRNA expression in rats following endotoxic shock].

OBJECTIVE: To investigate the potential role of changes in biopterin (tetrahydrobiopterin and more oxidized species) synthesis and GTP cyclohydrolase I (GTP-CHI) mRNA expression in endotoxic shock. METHODS: SD rats were subjected to endotoxic shock by a bolus injection of lipopolysaccharide (15 mg/kg, i.p.), biopterin and GTP-CHI mRNA levels in liver, kidney, and intestine were determined at 4, 8 hours following endotoxin challenge. RESULTS: Tissue biopterin levels significantly elevated in liver, kidney, and intestine, with high levels sustaining for 8 hours after endotoxin challenge (P < 0.05, P < 0.01). Similarly, GTP-CHI mRNA induction in various tissues substantially increased within 4 hours compared to normal controls (P < 0.05, P < 0.01). It was also shown that hepatic and renal biopterin levels were positively correlated with glutamic pyruvic transaminase (GPT) and also blood urea nitrogen (BUN) values (both P < 0.01). In addition, treatment with recombinant bactericidal/permeability increasing protein (rBPI(21)) markedly reduced tissue biopterin and GTP-CHI mRNA levels, concomitant with significant decreases in GPT, BUN as well as D-lactate values. CONCLUSIONS: Biopterin synthesis and release may be involved in the development of endotoxin-induced multiple organ dysfunction, and early use of rBPI(21) is effective to inhibit marked GTP-CHI mRNA expression and biopterin formation following septic shock.

Animals↗