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 study the carbapenemase genotypes among Acinetobacter calcoaceticus isolates infected after liver transplantation. METHODS The 5.4 software was used to analyze the resistance of Acinetobacter species. Eight strains of imipenem-resistant A. calcoaceticus which were resistant to multiple drugs were collected. Analytical isoelectric focusing electrophoresis was used to measure the pI of the ?-lactamase. The homology of the isolates was determined by pulsed field gel electrophoresis(PFGE). blaTEM, blaSHV, blaIMP, blaVIM, blaOXA Genes for resistant isolates were amplified and sequenced. RESULTS Imipenem-resistant A. calcoaceticus infected after liver transplantation was resistant to multiple drugs. All of 8 strains were produced OXA-23 carbapenemases (pI of 6.7). The results of PFGE indicated there was a trend of resistant clone transmisstion in the transplantation ward. CONCLUSIONS There is a transmisstion of A. calcoaceticus producing OXA-23 carbapenemase in the transplantation ward of our hospital. It is important to monitor powerfully the bacterial resistance to control infection more effectively.

Objective To study infection of the lung tissue by bronchoalveolar lavage for BALF and explore whether GM can help improve the he diagnosis efficiency in patients without granulocyte deficiency with IPA, and find the threshold of GM values. Methods Between January 2011 and December 2011, 173 cases of patients were considered possible invasive pulmonary aspergillosis in parallel BALF GM detection in the center of the respiratory endoscopic examination.. According to the diagnostic criteria at home and abroad, all the cases were divided into four groups, including group of IPA, group of tuberculosis, group of bacterial pneumonia and group of non-infection. Using ELISA method for determination of serum and BALF GM. The diagnostic value was made by statistical methods in BALF GM detection without patients of granulocyte deficiency with IPA. Results There were 11 cases in the group of IPA, 23 cases in the group of tuberculosis, 90 cases in the group of bacterial pneumonia and 49 cases in the group of non-infection. In patients without granulocyte deficiency with IPA,BALF GM value was higher comparing with the patients without IPA. There were significant difference between the two groups; Comparing the GM value in the serum, the detection of BALF GM was higher in IPA. ROC curve analysis found that when the BALF GM test value was 0.95 or higher, there was highest possible with IPA. Conclusion BALF GM testing is beneficial to patients of invasive pulmonary aspergillosis without granulocyte deficiency in early identification with IPA. This study found that BALF GM best value is 0.95 or higher.

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 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.

The application of resonance charging circuit to electro-hydraulic impulse apparatus for treating wastewater is introduced in this paper.The circuit permits the graduating increase of current without influence from time.The unique change of voltage on capacitor is favorable for the recovery of electric strength of electro-hydraulic impulse apparatus.The theory and design method of resonance charging circuit are provided.

BACKGROUND: At present, bone morphogenetic protein (BMP) is the only cytokine characterized as the ability of osteoblast, and it can promote marrow mesenchymal stem cells (MSCs) differentiating into chondroblast and osteoblast.OBJECTIVE: To investigate the differentiation into osteoblast from MSCs of rabbits transfected by human bone morphogenetic protein-7 (hBMP-7) gene with genetic engineering technique. DESIGN: Single sample observation. SETTING: Department of Orthopaedics, the First Hospital Affiliated to Sun Yat-sen University. MATERIALS: pcDNA1.1/AMP-hBMP7 plasmid.METHODS: The experiment was completed at the Surgery Laboratory of the First Hospital Affiliated to Sun Yat-sen University from May 2004 to March 2005. MSCs of rabbits were cultured with whole bone marrow technique, transfected with pcDNA1.1/AMP-hBMP7 and pcDNA1.1/AMP plasmids respectively in vitro, and left the blank controls. Transcription and expression of transfected genes were detected so as to observe form and growth of cells. Component of calcium content in cytoplasm was measured and osteogenic phenotype was identified with alkaline phosphatase (ALP) staining, calcium salts staining and transmission electron microscopy (TEM).MAIN OUTCOME MEASURES: ① Form and growth of MSCs of rabbits; ② evaluation of expressive product; ③ results of ALP staining (Ca-Co technique); ④ results of chinalizarin staining; ⑤ results of TEM; ⑥ results of scanning electron m icroscopy (SEM); ⑦ assay of osteocalcin.RESULTS: hBMP-7 gene was contained in MSCs after transfection and expressed the relevant mRNA. Cellular form changed a little after expression of amid genes, but growth curve did not changed as compared with that in non-transfected group. Expression of osteocalcin was increased as compared with that in non-transfected group, and ALP staining and calcium salts staining of transfected cells were positive.CONCLUSION: Transfection of hBMP-7 gene can promote MSCs of rabbits differentiating into osteoblast.