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Dr. Wang has engaged in surgery and burn medicine for 61 years. He is one of the first generation of burn doctor in China, who treated burn patients more than ten thousands and went to dozens of cities and areas to rescue the wounded near hundred batches. He made contribution to the establishment of Chinese special scheme for treating burn patients. He established the institute lab of metabolism and nutrition in 1985, and treated burn patients and carried out research of burn metabolism and nutrition simultaneously. He developed new theory that other routes like internal organs especially intestine besides burn wound can induce hypermetabolism i. e." enterogenous hypermetabolism" . If gut works, early feeding (EF) and enteral nutrition (EN) are better than delayed feeding and parenteral nutrition, and EN or EF can promote gastrointestinal resuscitation, reduce intestine injury, modulate hypothalamus and pituitary function, and decrease hypermetabolism. At the end of the 1980s, by measuring the resting energy expenditure of 105 adult burn patients and normal adults, they worked out the first formula for calories supply in Chinese burn adults. He published 340 papers, while 50 papers were exchanged in international meeting, and published 53 monographs (as editor or associate editor in chief for 9 books). Metabolism and Nutrition in Burns is the 1st burn metabolism and nutrition book in China. We got 24 awards of nation, army, and provincial and ministerial level in science, technology, medicine, and education, and there were two awards of " National 2nd Science and Technology Award" (respectively the 1st and 2nd author). He was the chairman of Burn Institute of Southwest Hospital during 1988-1999, and the institute was appraised as " Model Unit of Grass-roots in General Logistics Department" and awarded the 1st and the 2nd collective merits during that time. He was the vice president of Chinese Burn Association and chief editor of Chinese Journal of Burns.
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Objective To investigate the serum levels of biochemical indexes such as calcium,phosphorus,iron,zinc,and alkaline phosphatase of children in Kaschin-Beck disease areas and control areas in Qinghai Province.Methods According to the results of Kaschin-Beck disease monitoring in Qinghai Province,Tangnaihai Township of Xinghai County and Gandu Town of Hualong County were chosen as Kaschin-Beck disease areas and Qushian Township of Xinghai Country was chosen as a control.Children aged 7 to 15 in boarding schools in these areas were chosen as the study subjects in June 2014.Serum alkaline phosphatase level was determined by enzyme colorimetry and the serum iron,zinc,calcium and phosphorus levels were determined by colorimetry.Calcium to phosphate ratio was calculated at the same time.Results Fifty-nine qualified serum samples of children were sampled in Kaschin-Beck disease areas and 45 in control area.Serum alkaline phosphatase levels in Kaschin-Beck disease areas and control area were (311.34 ± 85.31) and (264.09 ± 73.44)U/L,respectively,and the difference was statistically significant (t =-2.97,P ＜ 0.05).Children's serum phosphorus levels in Kaschin-Beck disease areas and control area were (1.62 ± 0.17) and (1.43 ± 0.13)mmol/L,respectively,and the difference was statistically significant (t =-6.29,P ＜ 0.05).Calcium to phosphorus ratio were 1.62 ± 0.17 and 1.82 ± 0.21,respectively,and the difference was statistically significant (t =5.53,P ＜ 0.05).Compared with the control area,the level of children's serum zinc was (19.96 ± 1.70) and (20.59 ± 2.45)μmol/L;the level of serum calcium was (2.59 ± 0.11) and (2.57 ± 0.11)mmol/L;and the level of serum iron was (15.06 ± 7.02) and (17.01 ± 6.70)μmol/L.The differences between these three biochemical indicators were not statistically significant between Kaschin-Beck disease areas and control area (t =1.39,-0.64,1.44,all P ＞ 0.05).Conclusion In Kaschin-Beck disease areas in Qinghai Province,the level of children's serum alkaline phosphatase and phosphorus have increased markedly and the calcium to phosphate ratio has decreased obviously.
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Embora a importância das interações medicamento-nutriente seja reconhecida, a abordagem sistemática para prevenção e monitorização destas interações como parte integrante da terapêutica, permitindo uma melhor predição das respostas clínicas, ainda é deficitária. O manejo inapropriado de algumas interações pode desencadear falha na terapêutica ou severos efeitos adversos ao paciente. A maior parte das interações envolve mudanças na biodisponibilidade oral e absorção, embora outros mecanismos também sejam sugeridos. Fatores que influenciam a interação medicamento-nutriente podem estar ligados ao hospedeiro, ao medicamento ou ao próprio nutriente. A maior parte das interações do tipo 1 podem ser evitadas, evitando-se a mistura do nutriente e o fármaco na mesma infusão. Enquanto algumas interações do tipo 2 podem ser evitadas separando-se o tempo de administração do medicamento e o nutriente, a maior parte das interações do tipo 2, envolvendo metabolismo e transporte, não pode ser evitada pela separação temporal da administração da alimentação e do medicamento. As interações relacionadas à nutrição enteral, indicam a recomendação de não administração de medicamentos diretamente na formulação enteral; não administração via sonda para nutrição, durante a nutrição enteral e a interrupção da mesma por duas horas antes e depois da administração de medicamentos. Princípios gerais para o manejo clínico e prevenção das interações medicamento-nutriente que poderão contribuir para implementar e facilitar a prática clínica, envolvem a identificação das consequências clínicas no curto e longo prazo, tais como sintomas clínicos e modificações de valores laboratoriais como resultado da interação, a consideração da necessidade de ajustes para doses de medicamentos ou suplementação nutricional e, considerações sobre a viabilidade de tratamento alternativo.
Although the importance of drug-nutrient interactions is recognized, a systematic approach to prevention and monitoring of these interactions as part of therapy, allowing better prediction of clinical response is poor. The inappropriate management of some interactions may trigger therapeutic failure or severe adverse effects to the patient. Most interactions involve changes in oral bioavailability and absorption, although other mechanisms are also suggested. Factors that influence drug-nutrient interaction may be linked to the host, the drug itself or the nutrient. Most of the interactions of type 1 can be prevented by avoiding the mixture of the same nutrient and drug infusion. While some interactions of type 2 can be avoided by separating the time of drug administration and the nutrient, most of the interactions of type 2, involving metabolism and transport, can not be avoided by temporal separation of the administration of food and medicine. The interactions related to enteral nutrition, indicate the recommendation of no drug administration directly into the enteral formula, not via the administration tube for nutrition, enteral feeding and during the same interrupt for two hours before and after drug administration. General principles for clinical management and prevention of drug-nutrient interactions that may contribute to implement and facilitate clinical practice, involving the identification of clinical consequences in the short and long term, such as clinical symptoms and changes in laboratory values as a result of the interaction, consideration of the need for adjustments to doses of medication or nutritional supplementation, and considerations about the feasibility of alternative treatment.
A pesar de la importancia de las interacciones fármaco-nutriente se reconoce, un enfoque sistemático para la prevención y el control de estas interacciones como parte del tratamiento, lo que permite una mejor predicción de la respuesta clínica es pobre. El manejo inadecuado de algunas interacciones pueden provocar fracaso terapéutico o efectos adversos graves para el paciente. La mayoría de las interacciones implican cambios en la biodisponibilidad oral y la absorción, aunque otros mecanismos también se sugirió. Factores que influyen en la interacción fármaco-nutrientes pueden ser vinculados a la acogida, la propia droga o de nutrientes. La mayoría de las interacciones de tipo 1 puede prevenirse si se evita la mezcla de los mismos nutrientes y la infusión de drogas. Mientras que algunas interacciones de tipo 2 se pueden evitar mediante la separación de la época de la administración de fármacos y nutrientes, la mayoría de las interacciones de tipo 2, del metabolismo y el transporte, no se puede evitar mediante una separación temporal de la administración de alimentos y medicinas. Las interacciones relacionadas con la nutrición enteral, indica la recomendación de no administración de la droga directamente en la fórmula de nutrición enteral, no a través del tubo de la administración de la nutrición, la alimentación enteral y durante la misma interrupción durante dos horas antes y después de la administración de drogas. Principios generales para la gestión clínica y la prevención de las interacciones entre medicamentos y nutrientes que pueden contribuir a poner en práctica y facilitar la práctica clínica, que incluirá la identificación de las consecuencias clínicas a corto y largo plazo, tales como los síntomas clínicos y los cambios en...
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Humans , Biochemical Phenomena , Food-Drug Interactions , Metabolism , Enteral NutritionABSTRACT
Objective To study the plasma antioxidant vitamin status in patients receiving enteral nutrition(EN) or parenteral nutrition(PN) after upper gastrointestinal surgery.Methods One hundred and twenty patients who underwent upper gastrointestinal cancer surgery were randomized into EN and PN group.The plasma vitamin A,vitamin E and ?-carotene levels pre-and post-operation and one week after clinical nutrition supplement were studied.Results Vitamin A and ?-carotene levels decreased significantly after surgery(P=0.03 and P=0.01,respectively).Vitamin E decreased 10 weeks after the nutrition,and it was significantly lower in the EN group than in the PN group(P0.05).Conclusions A decrease of antioxidant vitamins is induced by surgery and vitamin E is recommended to be given in nutrition supplement patients,especially in the patients receiving EN.