ObjectiveTo investigate the role of recombinant human growth hormone (rhGH) in the treatment of patients with multiple organ dysfunction syndrome (MODS). MethodsThirty-eight patients with MODS routinely treated with antibiotics and nutrition support were divided into two groups: the rhGH group and control group. The rhGH group was treated by subcutaneous injection of 5 U rhGH for two weeks. ResultsOn the 7th day of treatment, the score of APACHE Ⅱ in the rhGH group was much higher than the control group, the levels of ALT, AST, BUN and Cre did not change much compared with the control group. The level of albumin in the rhGH group increased (P＜0.05). The stay in ICU, time of mechanical ventilation and hospital stay decreased compared with the control group (P＜0.05). ConclusionrhGH can effectively improve the pathophysiology of critically ill patients and has no side effects on the function of liver and kidney, meanwhile it can shorten hospital stay and decrease mortality.
ObjectiveTo investigate whether the recombinant human growth hormone (rhGH) can promote endothelialization, inhibit vascular intimal hyperplasia, and improve long-term patency rate by the treatment of rhGH after vascular prostheses bypass. MethodsBetween August 2007 and January 2009, 94 patients with lower extremity arteriosclerotic occlusive disease were treated. Among them, 32 patients (34 limbs) who met the selection criteria were enrolled in this study. All cases were randomly divided into study group (16 cases, 18 limbs) and control group (16 cases, 16 limbs). There was no significant difference (P>0.05) in gender, age, disease time, location of lesions, the Trans-Atlantic Inter-Society Consensus (TASC) grade, and basic diseases between 2 groups. The patients with superficial femoral artery disease received above-knee femoro-popliteal prostheses bypass. The patients who had combined abdominal-iliac artery disease received concurrent abdominal-femoral and femoro-popliteal prostheses bypass. Subcutaneous injection of 9 U rhGH was given every night for 7 days in study group, and saline was applied in control group. Ultrasonography was taken after 2 weeks and 3 months of operation to observe the patency and measure the wall thickness of vascular prostheses. ResultsAfter operation, 1 patient of control group died of renal failure caused by acute thrombosis. After 2 weeks, ultrasonography showed no obvious intimal hyperplasia in 2 groups; the wall thickness was (0.13±0.02) cm in study group and (0.15±0.03) cm in control group, showing no significant difference (t=-1.720, P=0.108). After 3 months, the wall thickness was (0.17±0.06) cm in study group and was (0.26±0.09) cm in control group, showing significant difference (t=-2.240, P=0.045). All cases were followed up 36-60 months (mean, 56.4 months). The 5-year primary patency rate was 52.5% in study group and 35.7% in control group, showing no significant difference (χ2=1.470, P=0.225). ConclusionThe rhGH can improve endothelialization in vascular prostheses and can inhibit postoperative vascular intimal hyperplasia in clinical application.
Objective To study the effect of recombinant growth hormone (rhGH) on improvement of liver function and liver regeneration in animal and patients after hepatectomy. Methods The liver cirrhosis model of SD species mouse was set up, then the mouse were randomly divided into experiment group and control group, then 30%-40% liver of all the models were resected, rhGH was used by hypodermic injection (0.2-0.4ml/100g) in experimental group, and the equal dose of N.S. were given in control group every day. Then liver function, arterial blood ketone body ratio(AKBR), and the regenerated liver/body weight ratio (RL/W) were determined, histopathology of the cirrhosis with microscope and electron microscope and the mitotic index (MI) of liver cell on 7, 14 and 28th day after operation were observed. Clinically,39 hepatectomized patients were randomly divided into experiment group and control group, liver function, PA， Glu, RI and AKBR were measured preoperatively and on 1, 7,14th day after operation. Postoperative clinical course were also compared between the two groups. Results In the animal experiment group, as compared with the control group, AKBR was obviously higher (P＜0.01), seruim level of total protein and PA were increased faster (P＜0.05), and RL/W was higher. The mitotic index of liver cell was increased faster on 14th day, the numbers of regenerated liver cell with double nucleus and rough endoplasmic reticulum were higher in 14 and 28th day. In the clinical experiment group, as compared with the control group, serum total bilirubin, alanine aminotransferase and aspartate aminotransferase were lower on 7 and 14th postoperative day (P＜0.05). Serum albumin, PA, Glu, RI and AKBR were higher on 7, 14th postoperative day (P＜0.05). Conclusion Both experimental and clinical study show that the rhGH can promote liver regeneration and improve liver function after hepatectomy.
To evaluate effect of recombinant human growth hormone (rhGH) on immunologic function in patients with gastrointestinal malignant tumor (GIMT). Before and 3 weeks after surgical treatment and administration of rhGH, the amount of T lymphocyte subset (T-LS) and soluble interleukin 2 receptor (sIL-2R) level were measured in 12 patients with GIMT, which were compared with 20 cases of normal control and 18 cases of GIMT treated by surgery alone. Result: ①In all GIMT patients, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 were lower than normal control and the sIL2R level was much higher; ②After operation, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 of all patients increased, the serum sIL2R level decreased; ③In patients recieved rhGH, the serum CD＋3, CD＋4 level and the ratio of CD＋4/CD＋8 were much more increased and the serum sIL-2R level much more decreased than those of surgery alone group. Conclusion: rhGH can enhance the immunologic function of patients with GIMT.
ObjectiveThe growth potential of children with short stature in middle and late adolescence may be limited by the effect of estrogen on epiphyseal closure. In recent years, the third generation of non-steroidal aromatase inhibitors (AIs) have been used in the treatment of short stature but with off-label. This study aimed to systematically review the efficacy and safety of the third-generation non-steroidal AIs in the treatment of children with short stature, and to provide evidences for rational drug use in clinical practice. MethodsWe searched PubMed, Embase, Cochrane Library, CNKI, WanFang Data, VIP and CBM from inception to December 28, 2022. Relevant studies on the treatment for children with short stature using the recombinant human growth hormone (rhGH) combined with or without the third-generation non-steroidal AIs were collected. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 18 articles were finally included, involving 9 randomized controlled trials and 9 cohort studies, with a total of 1 053 patients. The Meta-analysis showed that: (1) in terms of efficacy, the final adult height (MD=2.48, 95%CI 2.02 to 2.94, P<0.01), predicted adult height (MD=4.27, 95%CI 2.71 to 5.83, P<0.01), predicted adult height difference (MD=4.26, 95%CI 3.23 to 5.28, P<0.01), bone age (MD=−0.62, 95%CI −0.89 to −0.36, P<0.01), bone age difference/actual age difference (MD=−0.47, 95%CI −0.56 to −0.37, P<0.01), and growth velocity (MD=1.34, 95%CI 0.89 to 1.78, P<0.01) at the end of treatment in the experimental group were better than those in the control group, but there was no statistical difference in the height at the end of treatment between the two groups (MD=4.03, 95%CI −0.01 to 8.06, P=0.05). (2) in terms of safety, the total incidence of adverse events in the experimental group (RR=2.10, 95%CI 1.48 to 2.99, P<0.01) was higher than that in the control group, among which the incidence of adverse events in the endocrine system and skin and subcutaneous tissue system was statistically different between the two groups (P<0.05), and the incidence of adverse events in the hepatobiliary system, kidney and urinary system, metabolism and nutrition, gastrointestinal system, musculoskeletal system, blood and lymph system, vascular and lymphatic system, and neuropsychiatric system was not statistically different between the two groups (P>0.05). ConclusionCurrent evidence shows that the third-generation non-steroidal AIs combined with rhGH can effectively improve the final height of children with short stature, but it may increase the incidence of adverse drug events. Limited by the quality and the follow-up period of the included studies, high-quality studies are still needed to demonstrate the above conclusions and further evaluate the long-term safety of AIs in children with short stature.
【Abstract】ObjectiveTo prospectively study the effects of recombinant human growth hormone (rhGH) on the changes of liver function and nutritional metabolism in postoperative patients with cirrhosis and portal hypertension. MethodsFortyeight cases with liver cirrhosis and portal hypertension who were collected from February 2003 to January 2004 were randomly divided into 2 groups (24 patients in each group). All patients were given the low calorie parenteral nutrition support and exogenous albumen after operations. Patients in the study group received rhGH from the second day after operations and physiological saline was used in the control group instead. The effects were evaluated in terms of protein metabolism, liver function, blood glucose level at different phases before and after the intervene. Death rates of in patients were also recorded in both groups. ResultsThe rising amplitude of albumen in the study group had been significantly larger than that of the control group from the seventh day after intervene (P＜0.05). The blood transaminase levels (ALT，AST) in the study group were significantly lower than that of the control group (P＜0.05). The blood glucose level of both groups decreased over time and returned to normal on day 14 after intervene, but there was no significant difference for both glucose and plasma bilirubin level between the two groups before and after the intervene (Pgt;0.05). The rates of death were similar, although the length of stay in the study group was much shorter than that of the control group. ConclusionrhGH may inhibit the catabolism, correct hypoproteinemia, improve liver function for postoperative patients with cirrhosis and portal hypertension, and reduce their length of stay.
ObjectiveTherapeutical effect of recombinant human growth hormone （rhGH) on obstructive jaundice and internal and external drainage was observed.MethodsNew Zealand white rabbits were randomly divided into groups below: obstructive jaundice internal drainage plus rhGH group, obstructive jaundice internal drainage plus NS group, obstructive jaundice external drainage plus NS group, and obstructive jaundice external drainage plus rhGH group. After the establishment of obstructive jaundice model, rhGH was used in the above groups. Subcutaneous injection of rhGH 0.2 IU/kg was given twice a day. Isovolume NS was used on the control groups. Full set of endotoxin, tumor necrosis factor, sIL2R and nutritional status were estimated before the model establishment, and 14 days after the model established, 14 days after internal and external drainage.ResultsFour days after internal and external drainage, body weight of therapy groups was increased compared with control groups (P＜0.05). Seven days and ten days after obstructive jaundice, blood sugar of therapy groups rised compared with control groups (P＜0.05). Albuminate, siderophilin and prealbumin of therapy groups were all observed an increase after 14 days after obstructive jaundice, and 14 days after internal and external drainage (P＜0.01). Blood total cholesterol, low density lipoprotein and omni bile acid of therapy groups after 14 days of obstructive jaundice were increased apparently (P＜0.05). Blood glutamicoxal acetic transaminase, transglutaminase, total bilirubin, blood uria nitrogen, creatinine and uric acid of therapy group after 14 obstructive jaundice days were increased (P＜0.05). Ca2+ of therapy groups 14 days after obstructive jaundice, 14 days after internal and external drainage rised as compared with control groups (P＜0.05). However, K+,Na+ of therapy groups 14 days after external drainage decreased (P＜0.05). An increasing tendency of sIL2R was observed in control groups 14 days after obstructive jaundice(P＜0.05) and ET,αTNF,sIL2R of control groups was decreased 14 days after internal and external drainage (P＜0.01).ConclusionAfter rhGH is used in obstructive jaundice and internal and external drainage, an improvement of nutritional status and immunological function can be observed.
Objective To explore the impact of recombinant human growth hormone （rhGH） on T lymphocyte subsets in patients with rheumatic heart disease during the perioperative period of heart valve replacement. Methods A total of 65 patients with rheumatic valvular heart disease who received heart valve replacement in Department of Cardiothoracic Surgery of Xiangyang Central Hospital from June 1， 2011 to March 31， 2012 were enrolled in this double-blind randomized controlled clinical study. All the patients were divided into 2 groups by random number produced by SAS software：the trial group and the control group. There were 35 patients in the trial group including 19 males and 16 females with their average age of 50.57 years， and 30 patients in the control group including 16 males and 14 females with their average age of 49.87 years. Apart from routine cardiac glycosides， diuretics， glucose-insulin-potassium solution， and postoperative anti-infective therapy， patients in the trial group also received subcutaneously injection of rhGH 5 U （1 ml）daily from 1 day before surgery to 3 days after surgery， and patients in the control group received subcutaneously injection of normal saline 1 ml as placebo. Peripheral venous blood samples were taken in the morning 2 days before surgery and 1 st， 3 rd， 7 th day after surgery respectively. Percentages of CD3+， CD4+， CD8+ were examined timely by flow cytometry and CD4+ /CD8+ ratio was calculated. Results In the control group， percentages of CD3+， CD4+ and CD4+ /CD8+ ratio on the 1st， 3rd， 7th postoperative day were significantly lower than preoperative levels， and percentages of CD8+ on the 1st and 3rd postoperative day were significantly lower than preoperative level （P＜0.05）. In the trial group， percentages of CD3+， CD4+， and CD8+ on the 1st and 3rd postoperative day were significantly lower than preoperative levels（P＜0.05）， while percentages of CD3+， CD4+， and CD8+ on the 7th postoperative day were not statistically different from preoperative levels （P＞0.05）; CD4+ /CD8+ ratio on the 1st postoperative day was significantly lower than preoperative level （P＜0.05）， while CD4+ /CD8+ ratios on the 3rd and 7th postoperative day were not statistically different from preoperative level （P＞0.05）. There was no statistical difference in preoperative T lymphocyte subsets between the trial group and the control group （P＞0.05）. The percentages of CD4+ and CD4+/CD8+ ratio in the trial group were significantly higher than those of the control group on the 1st postoperative day （P＜0.05）， while the percentages of CD3+ and CD4+ and CD4+ /CD8+ratio in the trial group were significantly higher than those of the control group on the 3rd and 7th postoperative day（P＜0.05）. Conclusion Use of rhGH can significantly increase T lymphocyte subsets expression， enhance body cellular immunity， and improve postoperative recovery of patients with rheumatic valvular heart disease during the perioperative period of heart valve replacement.
目的:探讨基因重组人生长激素(recombinant human growth hormone, rhGH)对特发性矮小儿童促身高增长的疗效。方法:ISS儿童60例,每晚睡前接受rhGH治疗0.15～0.18 IU/(kg·d),疗程3～9个月,并对其疗效进行观察。结果:ISS患儿经生长激素治疗后,生长速率明显增快,由治疗前4.21±0.36 cm/年提高到治疗后8.29±4.72 cm/年,差异有显著性(Plt;0.05)。而骨龄和体重无明显变化,差异不显著(Pgt;0.05)。治疗期间除少数肝功能轻度异常,注射部位轻度反应外,未发现明显副作用。结论:rhGH对ISS儿童有增快生长速度作用。
Objective To evaluate the effect of recombinant human growth hormone(rhGH) on growth of human colonic cancer cells (COLO-320) in vitro. Methods Human COLO-320 cells in logarithm growing period were cultured for 24 h,48 h or 72 h with variant concentrations of rhGH,camptothecine (CPT) or rhGH combined CPT in calf serum(serum group) or calf serum-free (serum-free group). Light density of cells were determined by MTT method, so that cellular inhibition rate were calculated.Results No influence on cell growth or inhibition rate was observed from cultures with variant concentrations and different acting times of rhGH (P＞0.05). Inhibition rate of single CPT or CPT combined rhGH were much more increased than single rhGH used (P＜0.01) with no statistical significance (P＞0.05).Conclusion The results show that rhGH has neither direct COLO-320 cells stimulation nor any evidence of COLO-320 cells inhibition, and has no influence of CPT on COLO-320 cells inhibition in vitro.