Objective:Comparative analysis of total parathyroidectomy (total parathyroidectomy, TPTX) and total parathyroidectomy with autoransplantation (total parathyroidectomy with autoransplantation, TPTX+ AT) for the treatment of uremia secondary hyperparathyroidism Clinical efficacy.Methods:A total of 82 cases of SHPT treated with TPTX or TPTX + AT in First Affiliated Hospital of Chengdu Medical College from June 2015 to July 2019 were collected According to the operation methods, 82 cases were devided into TPTX group and TPTX+ AT group.There were 34 patients in the TPTX group, 17 males and 17 females, with an average age of (45.97±8.96) years, and 48 patients in the TPTX+ AT group, 21 males and 27 females, with an average age of (49.12±7.30) years. SPSS 20.0 software was used for statistical analysis. The measurement data conforming to normal distribution were represented by ( Mean± SD), and the comparison between groups was performed by t test. The data not conforming to normal distribution were represented by quaternary M( P25, P75), and the comparison between groups was performed by non-parametric test. Enumeration data were expressed as cases (%), and comparison was performed by χ2 test. The postoperative complications, postoperative efficacy and recurrence rate were compared between the two procedures. Results:Both TPTX and TPTX+ AT had a low incidence of complications after SHPT, and both of them could effectively relieve symptoms such as bone pain, skin itching and subcutaneous soft tissue calcification.After 1 year of follow-up, both of the two surgical methods can effectively reduce blood calcium (TPTX group: t= 14.522, P<0.05; TPTX+ AT group: t=13.704, P<0.05), blood phosphorus (TPTX group: t=35.022, P<0.05; TPTX+ AT group: t=42.303, P<0.05) and iPTH(TPTX group: t= 20.166, P<0.05; TPTX+ AT group: t= 23.976, P<0.05), but the reduction of iPTH in TPTX group was more effective than that in TPTX+ AT group ( t=-3.416, P<0.05). Conclusion:Both TPTX and TPTX+ AT can effectively treat SHPT, and have high safety and can be used as an alternative for SHPT treatment.

Objective To detect the changes of number and function of endothelial progenitor cells (EPCs) in gld.apoE-/-C57BL/6 mice,and to investigate whether premature atherosclerosis of gld.apoE-/-C57BL/6 mice was mediated by the dysfunction of these EPCs.Methods EPCs were isolated from peripheral blood and bone marrow of four types of C57BL/6 female mice:gld+/+apoE+/+,gld,apoE-/-and gld.apoE-/-.The percentage of EPCs was analyzed by FACS as CD11b-Sca-1+CD309+ cells.The attached cells were stained with DiI labeled acetylated low-density lipoprotein (DiI-ac-LDL) and FITC-labeled Ulex Europaeus agglutinin 1 (FITC-UEA-1) double staining to determine their phagocytic function.The adherent function of EPCs was determined by calculating the number of re-cultured EPCs.The capacity of EPCs to form the cavity structure was detected by calculating the number of the formed vascular-like structure.Results The percentage of circulating EPCs was significantly decreased in the gld.apoE-/-group (0.012±0.002)％ compared to the gld+/+ apoE+/+ group [(0.039±0.005)％,P＜0.01],the gld group [(0.025±0.001)％,P＜0.05],and the apoE-/-group [(0.028±0.002)％,P＜0.01].The percentage of bone marrow derived EPCs was decreased in the gld.apoE-/-group (0.12±0.01)％ compared to the gld+/+apoE+/+ group [(0.42±0.05)％,P＜0.05].The percentage of DiI-acLDL and FITC-UEA-1 double positive cells was decreased in the gld.apoE-/-group [(59.2±2.1)％] compared to the gld+/+apoE+/+ group [(87.5±3.0)％,P＜0.01],and the gld group [(84.2±6.0)％,P＜0.01] ; the adherent function of EPCs was impaired in the gld.apoE-/-group [(50.0±5.3)％] compared to the gld+/+ apoE+/+ group [(86.0±7.3)％,P＜0.01],the gld group [(73.0±1.0)％,P＜0.01],and the apoE-/-group [(65.0±4.0)％,P＜0.05] respectively.The capacity of EPCs to form the cavity structure was decreased in the gld.apoE-/-group (4.0±0.3) compared to the gld+/+apoE+/+ group (12.0±1.4,P＜0.01).Conclusion The number of EPCs is decreased in the gld apoE-/-C57BL/6 mice,the adhesion,phagocytosis and angiogenic function of EPCs in the bone marrow are impaired,which may be one of the causes of lupus with atherosclerosis.

OBJECTIVE: To provide reference for the improvement of management quality of high-alert medications in ward area. METHODS: Risk management was used to estimate risk factor of commonly used high-alert medications in ward area. Then the homologous management measures were formulated based on potential risk. RESULTS: With enforcement of risk management, risk awareness of relevant responsible person was strengthened. They knew more knowledge about high-alert medications and its rate increased from 60% to 96%. The phenomena such as nonstandard storage and placement of drugs, unclear identification had never happened again. CONCLUSION: The application of risk management in high-alert medications contributes to improve anti-distress awareness of relevant responsible person, guarantee safety of drug use and enhance the quality of care.

Gas gangrene is an emergency condition, which usually develops after injuries or surgery. This study was designed to investigate clinical characteristics, appropriate therapy, and effective control of nosocomial cross-infection of gas gangrene in Wenchuan earthquake victims. Data on diagnosis, treatment, and prevention of confirmed, suspected, or highly suspected gas gangrene were collected. Sixty-seven (2.41%) cases of suspected gas gangrene were found, in which 32 cases were highly suspected of gas gangrene and 5 cases were confirmed by culture of Clostridium perfringens. Thereof, injury sites were mainly located on the limbs, and typical indications, including crepitation, severe localized pain, swelling, wound discoloration, dark red or black necrotic muscle, foul smell as well as different degrees of systemic toxic performance were common among them. After hospitalization, all patients were isolated and had surgery quickly to remove dead, damaged or infected tissue. The wounds were also exposed for drainage and washed or padded with 3% liquid hydrogen peroxide for disinfection before all diagnostic test results were available. Additionally, high doses of antibiotics (mainly penicillin) were given for the prevention of infection, and supportive therapy was applied for corresponding symptoms control. Among those cases, no fatality was reported. In summary, in post-disaster emergency relief, the diagnosis of gas gangrene should be primarily based on clinical manifestations; while patient isolation, wound debridement and disinfection, as well as antibiotics treatment, is the main measures for proper treatment and control of nosocomial infection for gas gangrene.

Gas gangrene is an emergency condition,which usually develops after injuries or surgery.This study was designed to investigate clinical characteristics,appropriate therapy,and effective control of nosocomial cross-infection of gas gangrene in Wenchuan earthquake victims.Data on diagnosis,treatment,and prevention of confirmed,suspected,or highly suspected gas gangrene were collected.Sixty-seven (2.41％) cases of suspected gas gangrene were found,in which 32 cases were highly suspected of gas gangrene and 5 cases were confirmed by culture of Clostridium perfringens.Thereof,injury sites were mainly located on the limbs,and typical indications,including crepitation,severe localized pain,swelling,wound discoloration,dark red or black necrotic muscle,foul smell as well as different degrees of systemic toxic performance were common among them.After hospitalization,all patients were isolated and had surgery quickly to remove dead,damaged or infected tissue.The wounds were also exposed for drainage and washed or padded with 3％ liquid hydrogen peroxide for disinfection before all diagnostic test results were available.Additionally,high doses of antibiotics (mainly penicillin) were given for the prevention of infection,and supportive therapy was applied for corresponding symptoms control.Among those cases,no fatality was reported.In summary,in post-disaster emergency relief,the diagnosis of gas gangrene should be primarily based on clinical manifestations; while patient isolation,wound debridement and disinfection,as well as antibiotics treatment,is the main measures for proper treatment and control of nosocomial infection for gas gangrene.