Objective To explore the experience of nursing the patients with hypoparathyroidism.Methods Five pregnant patients with hypoparathyroidism hospitalized in our hospital during January 2009 to December 2015 were included in the study.The nursing intervention included performance of health care during pregnancy,childbirth and postpartum nursing.Results The thyroid function of the 5 patients became normal after medication and delicate care.All underwent cesarean resection and all the infants were normal in terms of thyroid function.Conclusions Pregnancy combined with hypoparathyroidism is of high risk and harmful for mothers and neonates.So they should be under management of high risk pregnancy.The prenatal,intrapartum and postpartum nursing measures should be implemented to ensure the safety of delivery.

Critical Illness ; therapy ; Fluid Therapy ; Humans

Objective To present the experience of surgical treatment of 12 patients with advanced carcinoma of esophagus involving aorta. Methods Resection of esophageal carcinoma and cervical esophago-gastrostomy or supraaortic esophago-gastrostomy were done in 12 patients. In all 12 patients, the resection of limited aortic adventitia was performed in 2 patients, excision of aorta and simple suture in 2 patients and aortoplasty with Gore-Tex patch in 7 patients, the resected segment was replaced with artificial vessel in 1 patient. Results Complete recovery was achieved in 2 weeks in 12 patients, without severe complications such as aortic fistula. Conclusion Surgical treatment expands the operative indications for patients suffering from esophageal carcinoma involving aorta and improves their life quality.

Objective To construct vectors based on adeno-associated virus type 2 (rAAV2) carrying bone morphogenetic protein-7 (BMP-7) and observe their expression in adipose-derived adult stem cells, which can be served as a new gene therapy method and cell source for bone tissue engineering. Methods The coding sequence (1. 3 kb) of BMP-7 was amplified by PCR from the pcDNAl. 1 ( + ) plasmid containing the human BMP-7 cDNA. After purified, the gene fragments were cloned into a plasmid pUC18 and termed plasmid pUC18-hBMP7. The recombinant pUC18-hBMP7 was digested and further ligated to the pSNAV by T4DNA ligase and termed plasmid pSNAV-hBMP7. BHK-21 cells were transfected with the purified pSNAV-BMP7 plasmid according to a standard calcium phosphate precipitation method. The cells were isolated and the integrity of hBMP7 gene was determined by polymerase chain reaction (PCR) using the above PCR primers. To package the virus, stably transfected BHK-21 cells were subsequently infected with recombinant herpes simplex virus type 1 (rHSV-1). The collected cells were processed by chloroform treatment, PEG8000/NaCl precipitation and chloroform extraction for purification. The tiler was determined using quantitative DNA dot blots and the purity was examined by sodium dodecyl sulphatepolyacrylamide gel electrophoresis. Following infection with rAAV2-BMP7 at multiplicities of infection of 1?105 vector genomes per cell and subsequent culture, adipose-derived adult stem cells were assessed qualitatively for BMP7 production. Results The recombinant plasmid pSNAV-hBMP7 was identified by PCR and digested with restriction enzyme. Transfection showed an efficiency of 90 % in ADAS cells. BMP-7 expression in ADAS cells was identified by Western blot. Conclusions The hBMP-7 recombinant adeno-associated virus vectors can be successfully constructed in vitro and rAAV2-hBMP7 can infect ADAS cells.

Objective To summarize and report the experiences of surgical treatment of infective endocarditis. Methods From March 1995 to March 2004, surgical operations were performed in 25 patients with infective endocarditis, 9 of who received emergency surgery and 16 received selective operation. Replacement of mitral valve was performed in 3, aortic valve replacement in 13, mitral and aortic valve replacement in 8, Bentall procedure in 1.Associated cardiac lesions included patent ductus arterioles in 1, ventricular septal defect in 2, rupture of Valsalvaps sinus in 1. Results There was one postoperative death, which gave an overall hospital mortality of 4%. Twenty-four patients were cured and improved. Conclusion Surgical operation should be the preferred mode of surgical correction for infective endocarditis. The timing of surgery and proper perioperative management are key factors for the successful treatment of infective endocarditis.

Objective To compare the effects of ureteroscopic lithotripsy (URL), minimally invasive percutaneous nephrolithotomy ( MPCNL) , retroperitoneal laparoscopic ureterolithotomy ( RLU) and open ureterolithotomy (UL) for the treatment of complex upper ureteral calculi. Methods The data of 281 patients with complex upper ureteral calculi from January 2005 to January 2013 were retrospectively reviewed. 48 patients of them received treatment of URL, 113 patients received MPCNL, 67 patients received RLU and other 53 patients received UL. Results Success rates of treatment at the first time were:URL 62.5% (30/48), MPCNL 92.9%(105/113),RLU 100%(67/67) and UL 100%(53/53) . The mean blood losses during the operation were:URL (9.2 ± 1.4) mL,MPCNL (72.5 ± 5.8) mL,RLU (43.1 ± 8.5) mL and UL (100.5 ± 9.2) mL. The average operation time of URL group was shorter than three other groups, and the difference was statistically significant (P< 0.05) . The average hospital stay of URL group was also shorter than three other groups ( < 0.05) . The difference was not statistically significant in complications among four groups after operation ( >0.05) . Conclusion Clinical characteristics of patients and individual require ment should be considered comprehensively before an individual treatment choice is made for the treatment of complex upper ureteral calculi.

To investigate the characteristics of acute respiratory distress syndrome(ARDS)in the casualties of a great earthquake in Wenchuan China on May 12,2008.Records of the hospitalized patients in ICU injured in the earthquakes were examined retrospectively.Among the total of 153 critical patients injured in the earthquake,52(34.0%)had ARDS.Among these 52 patients with ARDS,24(46.2%)had multiple organ dysfunction syndrome(MODS).9(17.3%)patients with ARDS dead.Approximate 34.0% of the casualties of a great earthquake in ICU had ARDS,MODS is a common associated conditions in these patients,infection phy a great role in these patients.

Objective To detect the microvessel density(MVD) marked by MIF protein in esophagus squamous cell carcinoma(ESCC), and to see if a relationship exists between microvessel density(MVD) and clinicopathologic features. Methods The expression of MIF in vascular endothelial cell in forty ESCC specimens was examined by immunohistocbemistry staining, calculated the mean of MVD and analysed the relationship with clinicopathologic features. Results The positive rate of MIF protein was 95.00 %(38/40) in ESCC vascular endothelial cell. Compared with the normal esophageal squamous tissue[32.50 %(13/40)], there was significant difference in statistics, the mean of MVD was 26.5±8.5. MVD was positively correlated with the tumor TNM stages and lymph node motastasis. Conclusion MIF can be used in tagging vascular endothelial cell, MVD of ESCC was positively correlated with the tumor TNM stages and lymph node metastasis. It might be an major prognostic factor in ESCC.

Objective To explore whether albumin corrected anion gap (ACAG) is associated with long-term mortality of sepsis patients.Methods Adult patients with a diagnosis of sepsis within the first 24 hours (from December 2013 to December 2014) admitted to the intensive care unit (ICU) were included via the Sepsis database of West China Hospital Sichuan University. To record their long-term survival, patients were followed up by telephone interview one year after enrollment. ACAG was calculated according to the anion gap (AG) level within the first 24 hours admitted to ICU, and patients were divided into normal ACAG group (ACAG 12-20 mmol/L) and high ACAG group (ACAG > 20 mmol/L), and clinical characteristics and 1-year mortality were compared between groups. Patients were also divided into survivors and non-survivors according to the 1-year survival outcome, and multivariate logistic regression analysis was conducted to find independent risk factors for long-term mortality of sepsis patients.Results A total of 296 sepsis patients were enrolled in the study, with 191 (64.5%) in the high ACAG group and 105 (35.5%) in the normal ACAG group. There were no significant differences in age, gender, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), Charlson cormobidity index (CCI) and other background variables between groups. Compared with the normal ACAG group, patients who suffered from multiple organ dysfunction syndrome (MODS) in the high ACAG group were more prone to develop renal and gastrointestinal injury (43.5% vs. 25.7%, 52.9% vs. 33.3%, respectively), had significantly higher serum creatinine [SCr (μmol/L): 89.0 (61.0, 148.0) vs. 67.1 (48.0, 86.0)], greater need for continuous renal replacement therapy (CRRT, 16.8% vs. 6.7%), and significantly shorter length of ICU stay and hospital stay [days: 11 (5, 22) vs. 16 (18, 31), 21 (14, 39) vs. 28 (20, 47)], with statistically significant differences (allP < 0.05). It was shown by Kaplan-Meier survival analysis that 1-year cumulative survival for the high ACAG group was significantly lower than that of the normal ACAG group (55.0% vs. 67.7%,P = 0.046). It was shown by multivariate logistic regression that ACAG [odds ratio (OR) = 1.201, 95% confidence interval (95%CI) = 1.115-1.293,P = 0.000], APACHE Ⅱ (OR = 1.053, 95%CI = 1.011-1.098, P = 0.014), the incidence of septic shock (OR = 2.203, 95%CI = 1.245-3.898,P = 0.007), fungus infection (OR = 3.107, 95%CI = 1.702-5.674,P = 0.000), acute renal failure (OR = 2.729, 95%CI = 1.134-6.567,P = 0.025) and complicated with malignancy (OR = 2.929, 95%CI = 1.395-6.148,P = 0.005) were independent risk factors contributing to increased 1-year mortality among sepsis patients.Conclusion ACAG was an independent risk factor for 1-year mortality of sepsis patients.

Objective To evaluate the detection methods for β‐lactamase in 3 kinds of Staphylococcus aureus to provide the basis for clinical laboratories selecting the best detection method .Methods 40 strains of Staphylococcus aureus were selected .With the BlaZ gene detection result as the gold standard for β‐lactamase detection ,the detection performance of the penicillin zone‐edge deter‐mination ,cloverleaf assay ,nitrocefin‐disk were evaluated .Results 20 strains of Staphylococcus aureus were the BlaZ gene positive detected by PCR and 20 strains were negative .The sensitivity of the penicillin zone‐edge determination method ,cloverleaf assay and nitrocefin‐disk were all 100 .00% and the specificity were 100 .00% .Conclusion Three kinds of β‐lactamase detection method have better sensitivity and specificity .So different laboratory can choose one of the method to detect β‐lactamase of staphylococcus aureus according to the actual situation .