Objective To investigate the protective effects and the mechanism of recombinant human growth hormone on the intestinal barrier function. Methods The literatures of recent years were reviewed and summarized． Results The recombinant human growth hormone not only prevent mucosal cells and immunological cells from apoptosis, but also antagonize the damage of NO, cytokines, as well as endotoxin on intestinal barrier. What’s more, it increases the intestinal uptake and utilization of glutamine. All of the above could maintain the integrity and functions of the intestinal barrier. Conclusion The recombinant human growth hormone protects the intestinal barrier function through different ways.
Objective To investigate the changes of gastrointestinal hormone and body composition in patients with gastric cancer after gastrectomy. Methods Thirty-eight patients with gastric cancer were divided into three groups: distal gastrectomy group, proximal gastrectomy group and total gastrectomy group and 9 volunteers as control group. The nutrition status and gastrointestinal function were evaluated by four times. The time of postoperative first anal exsufflation and defacation, hospital stay and complications were recorded, and the pre-meal and the post-meal level of gastrointestinal hormones 1 month after operation were detected. Results Compared with control group, the basic levels of somatostatin (SS), cholecystokinin (CCK) and motilin (MTL) of distal gastrectomy group, proximal gastrectomy group and total gastrectomy group significantly increased (Plt;0.01). The post-meal level of gastrointestinal hormones significantly increased as compared with the pre-meal level in each group (Plt;0.01). The CCK in proximal gastrectomy group was lower than that of distal gastrectomy group and total gastrectomy group (Plt;0.01). The postoperative body weight and body composition in each group decreased. One month after operation, patients of total gastrectomy group got the lowest body weight (Plt;0.01). The decreasing level of fat free mass (FFM) was listed by total gastrectomy group, proximal gastrectomy group and distal gastrectomy group. The edema index had significant difference in distal gastrectomy group, proximal gastrectomy group and total gastrectomy group (Plt;0.01), and total gastrectomy group was the most obvious. The postoperative passing flatus and defecation time and average hospital stay in total gastrectomy group were significantly prolonged (Plt;0.05). The gastrointestinal symptoms score among three groups was significantly different (Plt;0.05). Conclusion There are different changes of gastrointestinal hormone and body composition in patients with gastric cancer after different gastrectomy, the basic levels of SS, CCK and MTL of distal gastrectomy group, proximal gastrectomy group and total gastrectomy group are higher than those of control group. The CCK of proximal gastrectomy group is lower than that of distal gastrectomy group and total gastrectomy group. Patients received total gastrectomy lose much body weight and FFM and get higher edema index.
Objective To determine the effects recombinant human growth hormone (GH) and hypocaloric nutrition on postoperative convalescence, we performed a placebo-controlled randomized double-blind trial in 18 patients after elective gastrectomy or colectomy. Methods The subjects received parenteral nutrition containing 20 calories/kg per day and 1 g protein/kg per day. Daily injections of drug or placebo were given during the first postoperative week. Result The nine control subjects lost 3.3 kg (5.9% of preoperative weight) and had a cumulative nitrogen loss of 32.6 ± 4.2 g nitrogen at eight days. The patients receiving GH lost significantly less weight (1.3 kg) and nitrogen loss was 7.3 ± 3.1 g at eight days (Plt;0.001). Kinetic studies demonstrated that anabolic effects of GH were associated with increased protein synthesis, and amino acid flus studies across the forearm revealed increased uptake of amino acid nitrogen in the GH-treated patients. Body composition analysis revealed that the patients receiving GH maintained their lean body mass despite the major surgical procedure. Conclusion We conclude that the postoperative catabolic response can be modified with GH and hypocaloric nutrition. The metabolic and physiologic effects should now be studied in a larger number of patients to determine if this approach can reduce morbidity, mortality, and length of hospital stay for surgical patients.
Objective
To summarize the progress of effect of gonadotropin-releasing hormone agonist on protecting ovarian function of young breast cancer patients who received chemotherapy, and to provide reference for clinical work.
Methods
Through searching of PubMed, CNKI, WanFang database, and other databases, we mainly collected relevant literatures in nearly five years, which concerning the effect of gonadotropin-releasing hormone agonist on protecting the ovarian function of young breast cancer patients who received chemotherapy.
Results
Young breast cancer patients faced with problems about long-term survival, quality of life, social psychological pressure, and other related problems. Chemotherapy caused irreversible damage to the ovarian function. Chemotherapy combind with gonadotropin-releasing hormone agonist could prevent premature ovarian failure and improve patients’ quality of life.
Conclusions
Gonadotropin-releasing hormone agonist combines with chemotherapy can protect the ovarian function of young breast cancer patients, and reduce premature ovarian failure and retain reproductive function with no serious adverse effect. In addition, it shall not affect the curative effect of chemotherapy itself, but this conclusion still needs further randomized controlled clinical trial to confirm.
Objective To study polyuria during mechanical ventilation in patients with chronic obstructive pulmonary disease ( COPD) and its possible mechanisms. Methods The plasma and urine concentrations of cystatin C ( CyC) were measured by enzyme immunometric assay in 26 COPD patients who received mechanical ventilation at timepoints of 0 h, 24 h, 48 h, 72 h and 1 week. And plasma levels of atrial natriuretic factor ( ANF ) , antidiuretic hormone ( ADH) and aldosterone ( ALD) were detected byradioimmunoassay at the same time-point. The urine volume was recorded every day. The samples of 30 healthy volunteers were measured as control. Results Polyuria phenomenon was found in majority of patients in 24 to 72 hours after mechanical ventilation. At 0h, the concentrations of plasma CyC, urine CyC,plasma ANF, ADH and ALD were all increased significantly compared with those of the control, respectively [ ( 4. 87 ±0. 51) mg/L vs ( 1. 29 ±0. 27) mg/L, ( 0. 58 ±0. 13) mg/L vs ( 0. 07 ±0. 02) mg/L, ( 37. 02 ±4. 35) pmol /L vs ( 22. 51 ±1. 18) pmol /L, ( 8. 61 ±1. 43) pmol /L vs ( 0.94 ±0. 34) pmol /L, ( 925. 4 ±142. 7) pmol /L vs ( 297. 5 ±135. 8) pmol /L, all P lt; 0. 01] , then decreased gradually after mechanical ventilation. The levels of plasma CyC and ANF at 24 h, plasma ADH at 72 h, and urine CyC at 1 week were similar to those of the control( all P gt;0. 05) , respectively, except the level of plasma ALD was still higher by 1 week( P lt; 0. 05) . Conclusions Polyuria is not a rare phenomenon for COPD patients receiving mechanical ventilation. Polyuria is related to the readjustment and mal-adaptation of ADH and reninangiotensin-aldosterone-systems during mechanical ventilation.
ObjectiveTo investigate the relationship between thyroid stimulating hormone (TSH) and the blood lipid level in patients with subclinical hypothyroidism (SCH).
MethodsWe carried out a retrospective analysis on the clinical data of 264 patients with their first diagnosis of subclinical hypothyroidism without treatment from 2010 January to 2014 January. A total of 288 healthy controls were chosen from communities. The patients were groups based on TSH≥10.0 mU/L and 3.6 mU/L≤ TSH< 10.0 mU/L. We investigated the relationship between TSH and the level of blood lipids by analyzing liver and renal function, blood lipids, thyroid function, and thyroid peroxidase antibody (TPO-Ab) in the patients.
ResultsTriglyceride (TG) and high density lipoprotein cholesterol levels were not significantly different among the three groups (P>0.05). Total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) levels of the group with TSH≥10 mU/L were respectively (5.93±1.12) and (3.82±1.11) mmol/L, which were significantly higher than those in the controls[(4.43±1.12) and (2.66±0.43) mmol/L] (P<0.05). TC, TG and LDL-C levels of the group with 3.6 mU/L≤ TSH< 10.0 mU/L were higher than the controls, but the differences were not significant (P>0.05). After thyroid hormone replacement therapy within 12 weeks, TG, LDL-C, and TC levels of TPO-Ab positive patients with subclinical hypothyroidism (n=112) were respectively (4.62±1.03), (2.97±0.52), and (1.17±0.62) mmol/L, which were significantly lower than those levels before treatment[(5.43±1.18), (3.62±0.58), and (2.03±0.71) mmol/L] (P<0.05).
ConclusionThe disorder of lipid metabolism exists in patients with subclinical hypothyroidism. Especially, the level of TSH greater than or equal to 10 mU/L is a high risk factor for dyslipidemia. In TPO-Ab positive patients, therapy of thyroid hormone replacement can effectively improve the blood lipid abnormalities in patients with subclinical hypothyroidism, and it may be an effective measure to improve the disorder of lipid metabolism economically and effectively.
ObjectiveTo research on the clinical efficacy of gonadotropin releasing hormone (GnRH) pump in the treatment of hypogonadotropic hypogonadism (HH) by using micropulse pump subcutaneous pump Gonadorelin to treat patients with HH.
MethodsThrough the report of one case of GnRH pump treatment patient and related literature review, we studied the effect of GnRH pump therapy and the traditional treatment on HH patients' sex hormone level, secondary sexual characteristics, spermatogenesis and pregnancy rate.
ResultsThrough treatment, GnRH pump effectively improved the patient's sex hormone level, secondary sexual characteristics development and sperm production ability, and eventually the patient attained the goal of fertility. The patient had a change in his voice tone; Beard and armpit hair grew out; The patient had a good mood with sexual drive; luteotropic hormone, follicle-stimulating hormone and testosterone became normal. The patient's sperm density was 20×109/L, and the average sperm motility was higher than 30%.
ConclusionPulse pump GnRH conforms to the physiological rhythm of GnRH secretion with a good clinical efficacy and tolerance. So we recommend GnRH pump as the preferential choice for treatment of hypogonadotropic hypogonadism.
ObjectiveTo analyze the changes of perioperative thyroid hormone in patients undergoing cardiac surgery under cardiopulmonary bypass, and to provide guidance for postoperative cardiac management.MethodsThe clinical data of 72 patients receiving cardiac surgery under cardiopulmonary bypass in our hospital from January to May 2019 were collected, including 35 males and 37 females, aged 19-72 (52.35±10.40) years. The changes of thyroid hormones before operation, 2 hours and 24 hours after operation were analyzed.ResultsThere was a statistical difference in thyroid stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine (T4) and free tetraiodothyronine (FT4) between postoperative 2 hours and preoperation (P<0.05). There was a statistical difference in TSH, T3, free triiodothyronine (FT3), T4 and FT4 between postoperative 24 hours and preoperation (P<0.05). There was a statistical difference in TSH, T3, FT3 and T4 between postoperative 24 hours and 2 hours (P<0.05). Postoperatively T3 and FT3 decreased, TSH increased and then decreased while T4 and FT4 were within the normal range. Repeated measures analysis of variance showed a statistical difference of time effect in TSH, T3, FT3, T4 and FT4.ConclusionPatients with cardiac surgery under cardiopulmonary bypass have different thyroid hormones postoperatively compared with preoperatively. T3 and FT3 decrease, TSH increases and then decreases, while T4 and FT4 are in the normal range. The results require further large-scale, multi-center, high-quality clinical studies to be confirmed.
The aim of this study was to establish stable expression of human thyroid stimulating hormone receptor (TSHR) α-subunit (hTSHRA) on human embryonic kidney 293T (HEK 293T). HEK 293T cell lines with stable expression of hTSHRA could be used for detecting affinity between hTSHRA and potential TSHR blocking-peptide. We firstly constructed hTSHRA gene into lentiviral vectors GV218. The sequence comparison indicated that we had constructed GV218-hTSHRAA. Western blot demonstrated the 52 kD aim band of hTHSRA on over-expressed HEK 293T cells. GV218-hTSHRA constructions and pHelper were then co-transfected into HEK 293T cells to form packaging plasmid. The HEK 293T cells that stably expressed hTSHRA could also express green fluorescent protein. The titer of lentiviral packaging vector is 2×108 TU/mL with qPCR. The lentiviral packaging vector thereafter was transfected into HEK 293T cells again. The hTSHRA expressed on the HEK 293T cells. Human TSHRA stably expressed on HEK 293T upon continuously passaging. Therefore, we established hTSHRA stable expression on HEK 293T cells by constructing GV218-hTHSR lentiviral packaging vector. It is a useful tool for studying TSHR affinity with anti-thyroid peptide.
ObjectiveTo investigate the perioperative change of parathyroid hormone (PTH) and its effect on cardiac function in patients with rheumatic heart disease.MethodsFrom January 2018 to June 2019, 76 patients were randomly divided into calcium supplement group (n=39) and control group (n=37). Mitral valve replacement was performed in both groups with cardiopulmonary bypass (CPB). Blood gas was measured immediately and every 6 h within 24 h after CPB. The patients in the calcium supplement group were given 1 g of calcium gluconate when hypocalcemia occurred, while the control group received no calcium supplementation. Values of radial arterial blood PTH and calcium ion (Ca2+) were measured in the two groups before operation (T1), at 30 min after starting CPB (T2), immediately after stopping CPB (T3), at 24 h after operation (T4), and at 48 h after operation (T5), respectively.ResultsThere were 71 patients enrolled in this study finally, including 38 in the calcium supplement group and 33 in the control group. The PTH values of patients in the two groups gradually increased, reached the peak at T3 time-point, then began to recover gradually. There was no significant difference between the two groups at T1, T2 or T3 time-point (P>0.05), while there were significant differences at T4 and T5 time-points (P<0.05). The Ca2+ values of the two groups gradually decreased after CPB, and gradually increased after blood ultrafiltration. There was no significant difference between the two groups at T1 or T3 time-point (P>0.05), while there were significant differences at T2, T4 and T5 time-points (P<0.05). The postoperative 24-hour values of ejection fraction (EF) and cardiac troponin T (cTnT) and the 72-hour total amount of epinephrine used in the calcium supplement group were (42.66±4.18)%, (1 881.17±745.71) ng/L, and (3.04±0.86) mg, respectively, and those in the control group were (40.76±3.39)%, (2 725.30±1 062.50) ng/L, and (4.69±1.37) mg, respectively. There were statistically significant differences in EF, cTnT and the 72-hour total amount of epinephrine used between the two groups (P<0.05). Values of PTH at T4 and T5 time-points were respectively negatively correlated with postoperative 24-hour value of EF (r=-0.324, P=0.006; r=-0.359, P=0.002), positively correlated with postoperative 24-hour value of cTnT (r=0.238, P=0.046; r=0.248, P=0.037) and the 72-hour total amount of epinephrine used (r=0.324, P=0.006; r=0.383, P=0.001).ConclusionsHyperparathyroidism occures after CPB, and calcium supplementation could relieve the hyperparathyroidism. Hyperparathyroidism may be related to postoperative cardiac insufficiency.
