1.Health risk assessment of heavy metals and metalloids in atmospheric PM2.5 from Inner Mongolia Autonomous Region in 2023
Jiake ZHU ; Shengmei YANG ; Yuhan QIN ; Nana WEI ; Wenqian ZHANG ; Xinrui JIA ; Wenyu ZHANG ; Xuanhao BAI ; Minghui YIN ; Li ZHANG ; Huan LI ; Duoduo WU ; Xuanzhi YUE ; Yaochun FAN
Journal of Environmental and Occupational Medicine 2025;42(10):1201-1208
Background The Inner Mongolia Autonomous Region is a vast area with a wide array of ecological environments, resulting in considerable regional variations in air pollution characteristics. Current research is limited by a scarcity of systematic, region-wide studies and risk assessments. Objective To assess the health risks associated with inhalation exposure to nine heavy metal and metalloid elements in atmospheric fine particulate matter (PM2.5) for the population of the Inner Mongolia Autonomous Region. Methods From the 10th to the 16th of each month throughout 2023, atmospheric PM2.5 samples were collected at designated monitoring sites in 12 leagues (cities) across the Inner Mongolia Autonomous Region to analyze the characteristics and trends in concentration. The health risk assessment model developed by the United States Environmental Protection Agency was employed to evaluate both the non-carcinogenic and carcinogenic risks associated with the heavy metal elements beryllium (Be), cadmium (Cd), chromium (Cr), hydrargyrum (Hg), plumbum (Pb), manganese (Mn), and nickel (Ni) and the metalloid elements stibium (Sb) and arsenic (As). Results In 2023, a total of
2.Effects of advanced platelet-rich fibrin/chitosan thermosensitive hydrogel on full-thickness skin defect wound healing in diabetic rats
Haoyi XUN ; Xiaowei SU ; Fangchao HU ; Xiangyu LIU ; Yushou WU ; Tian LIU ; Ran SUN ; Hongjie DUAN ; Yunfei CHI ; Jiake CHAI
Chinese Journal of Burns 2024;40(5):451-460
Objective:To prepare advanced platelet-rich fibrin (A-PRF)/chitosan thermosensitive hydrogel (hereinafter referred to as composite hydrogel) and explore the effects of composite hydrogel on full-thickness skin defect wound healing in diabetic rats.Methods:This study was an experimental study. The composite hydrogel with porous mesh structure and thermosensitive characteristics was successfully prepared, containing A-PRF with mass concentrations of 10, 15, 20, 50, and 100 g/L. Diabetic model was successfully established in male Sprague-Dawley rats aged 6-8 weeks by intraperitoneal injection of streptozotocin, and 4 full-thickness skin defect wounds were established on the back of each rat (finally the model was successfully established in 36 rats). Three wounds of each rat were divided into blank group (no drug intervention), positive control group (dropping recombinant human granulocyte-macrophage stimulating factor gel), and chitosan hydrogel group (dropping chitosan hydrogel solution). Thirty rats were collected, and the remaining one wound of each rat (totally 30 wounds) was divided into 10, 15, 20, 50, and 100 g/L composite hydrogel groups, with 6 wounds in each group, which were dropped with composite hydrogel solution containing 10, 15, 20, 50, and 100 g/L A-PRF, respectively. Taking the remaining six rats, the remaining one wound from each rat was dropped with composite hydrogel solution containing 100 g/L A-PRF. On 14 d after injury, 6 rats with one wound dropped with composite hydrogel containing 100 g/L A-PRF were selected for hematoxylin-eosin (HE) staining to observe the inflammation, hemorrhage, or necrosis of the heart, liver, spleen, lung, and kidney. On 10 d after injury, 6 rats with one wound dropped with composite hydrogel containing 15 g/L A-PRF were selected to observe the blood perfusion of wounds in the four groups (with sample size of 6). On 7 and 14 d after injury, the wound healing rates in the eight groups were calculated. On 14 d after injury, the wound tissue in the eight groups was taken for HE and Masson staining to observe the formation of new epithelium and collagen formation, respectively; the positive expressions of CD31 and vascular endothelial growth factor A (VEGFA) were detected by immunohistochemistry, and the percentages of positive areas were calculated; the protein expressions of CD31 and VEGFA were detected by Western blotting; the mRNA expressions of CD31 and VEGFA were detected by real-time fluorescent quantitative reverse transcription polymerase chain reaction method (with all sample sizes of 4).Results:On 14 d after injury, no obvious inflammation, hemorrhage, or necrosis was observed in the heart, liver, spleen, lung, and kidney in the 6 rats. On 10 d after injury, the blood perfusion volume of wound in 15 g/L composite hydrogel group was significantly more than that in blank group, positive control group, and chitosan hydrogel group, respectively (with P values all <0.05). On 7 and 14 d after injury, the wound healing rates of blank group were (26.0±8.9)% and (75.0±1.8)%, which were significantly lower than those of positive control group, chitosan hydrogel group, and 10, 15, 20, 50, and 100 g/L composite hydrogel groups, respectively ((45.8±3.2)%, (49.8±3.7)%, (51.2±2.9)%, (68.5±2.4)%, (68.8±1.5)%, (72.7±2.1)%, (75.0±3.7)% and (79.1±1.9)%, (77.2±1.7)%, (82.3±1.3)%, (89.6±1.9)%, (89.8±1.3)%, (87.3±1.1)%, (87.9±1.3)%), P<0.05; the wound healing rates of positive control group, chitosan hydrogel group, and 10 g/L composite hydrogel group were significantly lower than those of 15, 20, 50, and 100 g/L composite hydrogel groups ( P<0.05). On 14 d after injury, the wound epithelialization degrees of 15, 20, 50, and 100 g/L composite hydrogel groups were higher than those of the other 4 groups, the new microvascular situation was better, and the collagen was more abundant and arranged more neatly. On 14 d after injury, the percentages of CD31 and VEGFA positive areas in wounds in positive control group and the percentage of VEGFA positive area in wounds in chitosan hydrogel group were significantly higher than those in blank group ( P<0.05), the percentage of VEGFA positive area in wounds in 10 g/L composite hydrogel group was significantly higher than that in blank group, chitosan hydrogel group, and positive control group (with P values all <0.05), and the percentages of CD31 and VEGFA positive areas in wounds in 15, 20, 50, and 100 g/L composite hydrogel groups were significantly higher than those in blank group, positive control group, chitosan hydrogel group, and 10 g/L composite hydrogel group ( P<0.05). On 14 d after injury, the protein and mRNA expressions of CD31 and VEGFA in wound tissue in chitosan hydrogel group, positive control group, and 10 g/L composite hydrogel group were significantly higher than those in blank group ( P<0.05); the protein expression of VEGFA in wound tissue in 10 g/L composite hydrogel group was significantly higher than that in positive control group ( P<0.05), and the mRNA expressions of CD31 and VEGFA in wound tissue in 10 g/L composite hydrogel group were significantly higher than those in positive control group and chitosan hydrogel group ( P<0.05); the protein and mRNA expressions of CD31 and VEGFA in wound tissue in 15, 20, 50, and 100 g/L composite hydrogel groups were significantly higher than those in blank group, positive control group, chitosan hydrogel group, and 10 g/L composite hydrogel group ( P<0.05); the mRNA expressions of CD31 and VEGFA in wound tissue in chitosan hydrogel group were significantly lower than those in positive control group ( P<0.05). Conclusions:The composite hydrogel has high biological safety, can improve wound blood perfusion, effectively promote the formation of blood vessels and collagen in wound tissue, thus promoting the wound healing of full-thickness skin defects in diabetic rats. 15 g/L is the optimal mass concentration of A-PRF in composite hydrogel.
3. Study on the factors affecting the steady-state blood concentration of tacrolimus in patients with autoimmune diseases
Wenpeng DU ; Jiangen AO ; Guansheng WU ; Jiake HE ; Yi TAO ; Jiake HE
Chinese Journal of Clinical Pharmacology and Therapeutics 2022;27(6):645-651
AIM: To investigate the effects of age, gender, duration of medication and combined medication on the steady-state blood concentration of tacrolimus in patients with autoimmune diseases, and to establish the reference range of steady-state blood concentration of tacrolimus in combination with liver and kidney function, so as to provide theoretical basis for clinical individual medication. METHODS: A total of 107 patients with autoimmune diseases treated with tacrolimus in the department of rheumatology and immunology of our hospital from August 2017 to June 2021 were included. Their gender, age, dose, drug combination, blood concentration, and liver and kidney function were statistically analyzed by SPSS 22.0 statistical software. RESULTS: In the treatment of autoimmune diseases with tacrolimus, there was statistical significance in the blood concentration of different genders (P<0.05), but there was no statistical significance in the blood concentration of different ages (P>0.05) and a statistically significant difference in the dosage of tacrolimus (P<0.05), the duration of medication did not affect the effective dose, target blood concentration, liver and kidney functions. There was a weak correlation between tacrolimus dose and blood concentration (r=0.115, P=0.047). When the blood concentration of tacrolimus ranged from 4.20 to 9.48 ng/mL, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and urea increased significantly. When tacrolimus blood concentration ranged from 0.08 to 4.20 ng/mL, there was no significant difference in serum creatinine, AST, ALT, albumin, total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL). CONCLUSION: Tacrolimus is used for the treatment of autoimmune diseases, and the blood concentration varies greatly among individuals. To avoid the risk of potential damage to liver and kidney function. It is recommended that clinicians control the blood concentration at 0.08-4.20 ng/mL, and adjust the dose and optimize the dose according to the patient's gender, age, and clinical efficacy.
4.Study on the factors of short-term prognosis of very elderly patients with acute coronary syndrome after interventional therapy
Nan ZHANG ; Yundi JIAO ; Sitong LIU ; Jiake WU ; Zongyu WEN ; Weili DUAN ; Zhijun SUN ; Zhaoqing SUN
Chinese Journal of Postgraduates of Medicine 2021;44(1):11-15
Objective:To investigate the characteristics of short-term prognostic factors in very elderly patients with acute coronary syndrome (ACS).Methods:A total of 2 912 ACS patients admitted to Shengjing Hospital of China Medical University from January 1, 2010 to October 31, 2014 and treated with percutaneous coronary intervention (PCI) were enrolled and divided into two groups according to age: very elderly group (≥75 years, 480 cases) and control group (< 75 years, 2 432 cases). The clinical data and coronary artery lesions of the included patients were detected. Major cardiovascular adverse events (MACE) occurred within 30 d after discharge were followed up and recorded. The short-term prognostic factors in very elderly patients with ACS were analyzed by Logistic regression.Results:Compared with control group, the percentage of hypertension, global registry of acute coronary events (GRACE) score, high density lipoprotein cholesterol, N-terminal pro-brain natriuretic peptide, the left main lesion ratio and Gensini score in very elderly group were higher, while the percentage of men, number of smoking, hyperlipidemia proportion, red blood cell count, white blood cell count, blood platelet count, albumin, and long term oral administration of aspirin, clopidogrel, statins, angiotensin receptor inhibitor after discharge were lower, and the differences were statistically significant ( P<0.01 or<0.05). During the follow-up period, the all-cause mortality in very elderly group was higher than that in control group: 2.5%(12/480) vs. 0.9% (21/2 432), and the difference was statistically significant ( P<0.01). Multivariate analysis showed that oral angiotensin converting enzyme inhibitor was a protective factor for elderly ACS patients after discharge ( OR = 0.046, 95% CI 0.006 to 0.383, P = 0.004). The receiver operating characteristic curve analysis showed that Gensini score ≥ 87.75 scores was a threshold value for all-cause mortality. The all-cause mortality ratio in high Gensini score (≥ 87.75 scores) group was higher than that in low Gensini score (<87.75 scores) group: 6.6% (9/137) vs. 0.9% (3/343), and the difference was statistically significant ( P<0.01). Conclusions:Very elderly patients with ACS have their own characteristics from both clinical history and prognostic factors. Patients with Gensini score of ≥ 87.75 scores should be closely observed, and drug treatment during hospitalization should be intensified if necessary. Follow-up should be strengthened for such patients, and oral drug treatment should be continued after discharge.
6.Clinical effects of pre-expanded anterior perforator flap of transverse cervical artery and pre-expanded thoracic random flap in reconstructing extensive facial and cervical scar in relay
Jian HOU ; Huifeng SONG ; Baoguo CHEN ; Minghuo XU ; Quanwen GAO ; Jue WANG ; Shuai CHEN ; Fang WANG ; Jiang WU ; Jiake CHAI
Chinese Journal of Burns 2021;37(4):350-355
Objective:To explore the clinical effects of pre-expanded anterior perforator flap of transverse cervical artery in extensive facial and cervical scar reconstruction and contralateral pre-expanded thoracic random flap in relay in donor site repair.Methods:A retrospective cohort study was conducted. From May 2008 to December 2018, 10 patients with extensive facial and cervical scar after burns were treated in the Fourth Medical Center of PLA General Hospital, including 8 males and 2 females, aged 10-55 years. In the first stage of operation, two skin and soft tissue expanders of the same volume (with rated capacity of 250-600 mL) were respectively placed in the right side and left side of the chest according to the size of scar, and then the skin was expanded. The total amount of normal saline injected was 2 to 4 times of the rated capacity of the expander. In the second stage, the defect with area of 12 cm×8 cm-23 cm×15 cm caused by scar resection and release was repaired with unilateral pre-expanded anterior perforator flap of transverse cervical artery with area of 12 cm×9 cm-24 cm×16 cm. The contralateral pre-expanded thoracic random flap with the same area as that of the above-mentioned perforator flap was extended to repair the secondary defect with area of 8 cm×6 cm-17 cm×14 cm formed after transfer of the above-mentioned perforator flap. The exploration of perforating branch of transverse cervical artery, flap transfer and survival, injury repair, and complications were observed. The appearance and related function of donor and recipient sites and satisfaction of patients were followed up.Results:The perforating branches of transverse cervical artery appeared stably in the 10 patients. All the flaps were transferred to the recipient area without tension and survived. Both facial and cervical injuries were repaired successfully with no common complications. During the follow-up of 6 months-8 years, the color and texture of the pre-expanded anterior perforator flap of transverse cervical artery matched with the surrounding tissue, the functions of head raising and neck rotation of patients were significantly improved compared with those before operation, the color and texture of the flap transplanted in the first donor site matched with the original skin, linear scar left at the surgical incision, and 9 patients were satisfied with the restoration of the appearance and function of donor and recipient sites.Conclusions:The color and texture of the pre-expanded anterior perforator flap of transverse cervical artery match well with the face and neck, and the repairable area is large. After the perforator flap is removed, the secondary wound can be repaired with the pre-expanded thoracic random flap at the same time, and the injury of the chest donor site is alleviated. This relay repair method is a good choice for reconstructing extensive facial and cervical scar.
7.Efficacy analysis of Da Vinci robotic and laparoscopic total mesorectal excision for low rectal cancer
Zhouzhou XU ; Shaihong ZHU ; Bo YI ; Jun LI ; Jiake LI ; Shurong WU
Chinese Journal of Digestive Surgery 2020;19(5):537-543
Objective:To compare the clinical efficacies of Da Vinci robotic and laparoscopic total mesorectal excision (TME) for low rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 64 patients with low rectal cancer who were admitted to the Third Xiangya Hospital of Central South University from October 2015 to January 2019 were collected. There were 42 males and 22 females, aged from 40 to 84 years, with a median age of 59 years. Of the 64 patients, 31 undergoing Da Vinci robotic TME and 33 undergoing laparoscopic TME were allocated into robotic group and laparoscopic group, respectively. Observation indicators: (1) surgical situations and postoperative recovery; (2) postoperative pathological examination; (3) follow-up. Follow-up using outpatient examination and telephone interview was conducted to detect long-term complications and pelvic autonomic nerve injury up to January 2020. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M ( P25, P75), and comparison between groups was analyzed using the rank sum test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was analyzed using the Mann-Whitney U test. Results:(1) Surgical situations and postoperative recovery: cases with anus preservation, cases with defunctioning stoma, cases with intraoperative conversion to laparotomy, cases with intraoperative blood transfusion, operation time, volume of intraoperative blood loss, time to postoperative first out-of-bed activities, time to postoperative first flatus, time to postoperative diet resumption, duration of hospital stay, cases with incision infection, cases with postoperative hemorrhage, cases with anastomotic fistula, cases with pulmonary infection, cases with urinary retention, comprehensive complication index for the whole group, comprehensive complication index for patients with complications, and treatment expenses of the robotic group were 30, 23, 0, 1, (285±73)minutes, (147±112)mL, (1.6±0.8)days, (3.6±1.1)days, (3.2±1.5)days, (9.8±2.8)days, 1, 4, 3, 1, 4, 15.0±12.0, 22.6(20.9, 27.3), (11.7±1.2)×10 4 yuan, respectively. The above indicators of the laparoscopic group were 22, 13, 2, 2, (253±57)minutes, (211±123) mL, (1.8±0.8) days, (3.9±1.6)days, (4.1±1.9)days, (11.8±4.3)days, 2, 5, 3, 3, 2, 20.0±12.0, 24.2(10.5, 30.8), (7.7±1.3)×10 4 yuan, respectively. There were significant differences in the cases with anus preservation, volume of intraoperative blood loss, duration of hospital stay, and treatment expenses between the two groups ( χ2=8.581, t=-2.065, -2.133, 12.700, P<0.05). There was no significant difference in the cases with defunctioning stoma, operation time, time to postoperative first out-of-bed activities, time to postoperative first flatus, time to postoperative diet resumption, comprehensive complication index for the whole group, or comprehensive complication index for patients with complications between the two groups ( χ2=2.425, t=1.957, -0.679, -0.846, -1.941, -1.867, Z=-0.850, P>0.05). There was no significant difference in the cases with intraoperative conversion to laparotomy, cases with intraoperative blood transfusion, cases with incision infection, cases with postoperative hemorrhage, cases with anastomotic fistula, cases with pulmonary infection, or cases with urinary retention between the two groups( P>0.05). One patient with anastomotic fistula in the robotic group was clipped under endoscopy, and the other patients with complications were cured after symptomatic treatment. (2) Postoperative pathological examination: distance from tumor to surgical margin, tumor diameter, case with positive or negative surgical margin, cases with highly, highly-moderately, moderately, moderately-poorly, poorly differentiated tumor (tumor differentiation degree), cases in stage Ⅰ, Ⅱ, Ⅲa+ b, Ⅲc+ Ⅳ (tumor pathological stage), the number of lymph node dissected were 1.0 cm(0.3 cm, 2.0 cm), (3.5±1.1)cm, 2, 29, 3, 7, 14, 5, 2, 5, 18, 4, 4, 16.0±2.8 of the robotic group, respectively, versus 1.3 cm(0.5 cm, 3.0 cm), (4.2±1.4)cm, 2, 30, 1, 7, 16, 6, 3, 1, 19, 7, 6, 13.9±3.8 of the laparoscopic group. There was a significant difference in the number of lymph node dissected between the two groups ( t=2.420, P<0.05) . There was no significant difference in the distance from tumor to surgical margin, tumor diameter, tumor differentiation degree, or tumor pathological stage between the two groups ( Z=-0.980, t=-1.912, Z=-0.809, -1.595, P>0.05). There was no significant difference in the surgical margin between the two groups ( P>0.05). (3) Follow-up: of the 31 patients in the robotic group, 29 were followed up for 3-24 months, with a median follow-up time of 12 months. Of the 33 patients in the laparoscopic group, 30 were followed up for 3-36 months, with a median follow-up time of 15 months. Cases with intestinal obstruction, cases with timely stoma closure, cases with local recurrence, cases with distant metastasis, cases with death, Wexner score at postoperative 12 months, international prostate symptom score at postoperative 12 months, times of nocturia at postoperative 12 months, international index of erectile function of the robotic group were 2, 20, 3, 2, 2, 0.0(0.0, 0.0), 4.5(1.3, 8.8), 1.5(1.0, 2.0), 2.0(1.3, 10.8), respectively. The above indicators were 4, 7, 3, 2, 3, 1.0(0.0, 3.0), 8.0(2.0, 14.3), 2.0(1.0, 4.0), 3.0(1.0, 11.8) of the laparoscopic group. There was no significant difference in the cases with intestinal obstruction, cases with timely stoma closure, cases with local recurrence, cases with distant metastasis, or cases with death between the two groups ( P>0.05). There were significant difference in the Wexner score and times of nocturia at postoperative 12 months between the two groups ( Z=-2.202, -1.986, P<0.05). There was no significant difference in the international prostate symptom score and international index of erectile function at postoperative 12 months between the two groups ( Z=-0.885, 0.094, P>0.05). Conclusion:Both Da Vinci robotic and laparoscopic TME for low rectal cancer are safe and effective, of which the former can improve the anal sphincter retention rate, reduce the nocturia frequency and enhance the protection of defecation function under the premise of radical resection of tumor.
8.Research progress in mechanism and preclinical treatment for blast traumatic brain injury
Chinese Journal of Trauma 2020;36(5):470-474
Blast traumatic brain injury (bTBI) often causes irreversible damage to the brain which seriously endangers the lives of the wounded and can be accompanied by various complications, and has high disability and morbility in peacetime and wartime. The bTBI is divided into primary injury and secondary injury, resulting in a series of neuropsychiatric symptoms. The mechanism of bTBI contains cracking effect, implosion effect, inertia effect and cavitation effect. Multiple factors, such as shrapnel injury caused by explosion, collision of body being thrown with hard objects and smash of buildings, can lead to brain injury. There are challenges in the diagnosis and treatment of bTBI, because the injury is often closed, the onset is slow, the diagnosis is easy to missed, the pathogenesis is complex, and the clinical manifestations vary. The authors review the mechanism of bTBI and its preclinical treatment, hoping to provide a way for the preclinical treatment of bTBI.
9.Treatment strategies for mass burn casualties transferred from a distance-clinical experience
Jiake CHAI ; Zhiyong SHENG ; Hongming YANG ; Xiaoming JIA ; Ligen LI ; Daifeng HAO ; Chuanan SHEN ; Yanqiu WU ; Liming LIANG
Medical Journal of Chinese People's Liberation Army 2005;30(2):117-120
This paper is to introduce our experiences in treating 2 batches of 13 burn victims transferred from remote areas on postburn days 3 and 4. Methods Thirteen burn victims of 2 mass casualties were transferred to our burns institute from remote areas on postburn days 3 and 4 on June 27, 2001 and June 2, 2002, respectively. There were 4 males and 9 females, age ranged from 20 to 43 years, with a mean age of 31.1±6.2 years. The mean total burn area was 74.3%±24.7% TBSA (range, 25% to 97%). Among them, 10 patients suffered from serious burn with mean total burn area involving 86.0%±11.5% TBSA (range, 60% to 97%), and mean full-thickness burn of 63.9%±26.3% TBSA. Four patients also manifested signs of severe inhalation injury, and 6 patients with moderate inhalation injury. In three patients with mean total burn area covering 35.5%±10.0% TBSA (range, 25% to 45%), with mean full-thickness burn of 15.3%±5.0%, were al having moderate inhalation injuries. Among these 13 patients, 3 were having high body temperature (39℃), while 3 manifested hypothermia. The heart rate was 140-160/min, and respiratory rate 26 to 32/min in 6 patients. Abdominal distension or loss of bowel sound were found in 4 patients. Low white cell and platelet count were found in some patients. In 13 cases, liver function, renal function, myocardiac enzyme, and coagulation function were abnormal. Results Among 13 burn victims, one patient died of myocarditis on postburn day 29, and another one died of hepatic failure (history of chronic hepatitis B) on postburn day 45 with only 2% TBSA of burn wound remained open. Conclusion Burns victims occurred in mass casualties who were transferred from remote areas to our Burns Institute were all in critical condition, usually with multiple complications, demanding most meticulous care. Our strategies in this regard consisted of dispatch of experienced surgeons and nurses to the referring hospitals and the airport to receive the patients to offer appropriate care to them during the journey,organization of the medical staff so that each of them was ordained specific function, thus conditions of the patients were evaluated immediately and appropriate treatment started expeditiously for those lethal complications on arrival. Timely and exact comprehensive treatments were prerequisite to save the patients’ life. Adequate metabolic support should be emphasized, and coagulant of anticoagulant treatment should be carried out when indicated.
10.The effects of recombinant human growth hormone on the metabolism of branch chain amino acid in severely burned patients.
Jiake CHAI ; Daifeng HAO ; Yanqiu WU ; Chuanan SHEN ; Zhiyong SHENG
Chinese Journal of Burns 2002;18(4):229-231
OBJECTIVETo explore the effects of recombinant human growth hormone (rhGH) when applied postoperatively on the metabolism of branch chain amino acid in severely burned patients.
METHODSFifty burn patients, aged 12 - 50 years and inflicted by more than 30% TBSA with 10% or more of III degree burn and admitted from the January of 1999 to the January of 2001 were enrolled in the study. The patients were randomly divided into rhGH treating (rhGH group) and control groups. Escharectomy was performed within 3 postburn day (PBDs). rhGH (0.3 IU/kg) was injected percutaneously every evening for ten days since the 1st postoperative day (POD). The changes of the plasma levels of GH and branch chain amino acid and the urine level of 3-methyl histidine (3-MH) were observed in the morning in the patients from the two groups.
RESULTSThe plasma GH level before operation decreased obviously in two groups of patients when comparing with normal value (P < 0.05). The plasma GH level in rhGH group was evidently higher than that in control group since the 3rd POD (P < 0.05). There was significant increase of the output amount of urine 3-MH in all patients, but which was obviously higher in control group than that in rhGH group (P < 0.05). The plasma levels of branch chain amino acid in burn patients before and one day after operation were lower than normal levels. The plasma levels of valine, isoleucine and leucine increased to peak values at POD 3 in rhGH group and at POD 7 in control group and decreased thereafter. The plasma branch chain amino acid level in rhGH group was evidently lower than that in control group since POD 7 (P < 0.05). The plasma GH level in rhGH group was negatively and significantly correlated with the urine output amount of 3-MH (P < 0.01).
CONCLUSIONPostoperative application of rhGH in major burn patients might be beneficial to the protein synthesis from amino acids by skeletal muscles and to the decrease of muscle protein degrading rate.
Adolescent ; Adult ; Amino Acids ; metabolism ; urine ; Burns ; blood ; metabolism ; urine ; Child ; Female ; Human Growth Hormone ; blood ; pharmacology ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; drug effects ; metabolism ; Recombinant Proteins ; blood ; pharmacology

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