1.Efficacy and safety of recombinant human growth hormone for postoperative recovery in patients with liver surgery: a Meta analysis
Yaochang GUO ; Zhongjian ZHENG ; Cuizhu WU
Chinese Journal of Hepatobiliary Surgery 2019;25(1):34-39
Objective To evaluate liver surgery (liver resection,liver transplantation,liver trauma) in patients with perioperative application of recombinant human growth hormone (rhGH) efficacy and safety.Methods We searched China biomedical literature database (CBM) and relevant randomized controlled Wanfang medicine,PubMed,Cochrane Library and Embase database to January 2018,application of rhGH for patients with liver surgery in rhGH,with placebo or blank control.According to certain criteria,the literatures were excluded and analyzed by RevMan 5.3 software.Results Total of 13 articles and 525 patients were included.The results showed that rhGH can improve the serum albumin (Alb),prealbumin (PA),transferrin (TF) synthesis [WMD =2.42,95%CI (0.45,4.40),P<0.05;WMD =28.44,95%CI (17.70,39.17),P<0.05;WMD=0.52,95%CI (0.44,0.61),P<0.05];high level of CD4/CD8 [WMD =0.40,95%CI (0.22,0.58),P<0.05];reduce the infection rate [RR=0.49,95%CI (0.31,0.77),P<0.05];shorten the hospitalization time [WMD=-3.19,95%CI (-5.77,-0.61),P<0.05];and will not increase the acute rejection and tumor recurrence rate,but need more exogenous insulin to control blood glucose.Conclusion Patients with perioperative application of rhGH can improve the nutrition status and immune function,reduce the rate of infection,promote the rehabilitation of patients,shorten the hospitalization time,and will not increase the acute rejection and tumor recurrence rate.
2.Meta-analysis of the efficacy of recombinant human growth hormone and human serum albumin in the treatment of liver cirrhosis with hypoproteinemia
Yaochang GUO ; Changming JIANG ; Wenlin SHU
Chinese Journal of Primary Medicine and Pharmacy 2020;27(23):2825-2829
Objective:To evaluate the efficacy, safety and economy of recombinant human growth hormone (rhGH) in the treatment of patients with liver cirrhosis and hypoproteinemia.Methods:Computer search for randomized controlled trials included in Chinese Biomedical Literature Database(CBM), Wanfang Medicine, Weipu Medicine, Embase, PubMed, Cochrane Library and other databases from January 1, 2000 to January 1, 2019, and excluded according to certain criteria.RevMan5.3 software was used for statistical analysis.Results:A total of 13 articles were included in the meta-analysis, a total of 739 patients.The results showed that the short-term efficacy of rhGH in the treatment of cirrhosis with hypoproteinemia had no statistically significant difference compared with human serum albumin (HSA)[WMD=-0.42, 95% CI(-1.77, 0.92), P=0.54], but the mid-and long-term effects of rhGH were better[WMD=3.42, 95% CI(0.13, 6.70), P=0.04; WMD=7.12, 95% CI(4.75, 9.50), P<0.001]. Conclusion:The application of rhGH in the treatment of cirrhosis with hypoproteinemia is equivalent to the infusion of HSA in short-term efficacy, but the duration of treatment is prolonged, has no obvious adverse reactions, and is more economical.
3.Pharmacy practice of medical order review in parenteral nutrition
Yaochang GUO ; Chengxian ZHANG ; Min ZHANG ; Lingyang CAI ; Jinsong ZHANG ; Yuan YUAN ; Qianwen ZHENG
Chinese Journal of Clinical Nutrition 2021;29(5):289-294
Objective:To establish rules for medical order review in parenteral nutrition, assist pharmacists in the efficient real-time pre-review of parenteral nutrition medical orders, and promote the standardized use of parenteral nutrition.Methods:Professional clinical nutrition pharmacists, prescription reviewing pharmacists, clinicians, and nutritionists jointly contributed to the formulation of custom prescription review rules for parenteral nutrition. Utilizing the prescription review system of our hospital, pharmacists reviewed and intervened parenteral nutrition medical orders in real time.Result:After the implementation of review rules, all of the medical orders for parenteral nutrition have been pre-reviewed in our hospital, and the related indicators that are out of normal range and the cases of single bottle infusion show significant reduction in frequency.Conclusion:The formulation and implementation of specific prescription review rules for parenteral nutrition can effectively assist pharmacists in real-time review of parenteral nutrition medical orders, and can solve the problems of inappropriate medical orders and single-bottle infusion.