Objectives:To discuss the characteristics of nursing care of patients with cardiomegaly after heart valve replacement operation.　Methods:From October 1997 to January 2000, 65 patients with cardiomegaly received heart valve replacement operations. According to the degree of cardiomegaly, these patients were divided into 3 types: left atrium, left ventricle and whole heart cardiomegaly. Different nursings were applied depending on the features of each type.　Results:Complications occurred in 28 patients(12 in left atrium,11 in left ventricle and 5 in whole heart cardiomegaly),all of whom were cured;2 patients died, the mortality rate was 3.08%.　Conclusions: To lower the morbidity and mortality, different kinds of nursing care should be applied to different cardiomegaly after heart valve replacement operations.

To explore the relationship between thyroid autoantibodies and thyroid function in school children aged 8-10 years,adults,pregnant women,and lactating women in China,in order to provide reference for the prevention and monitoring of thyroid disease.Healthy 8-10 years old school children (693 cases),adults (698 cases),pregnant women(325 cases),and lactating women(332 cases) from six iodine sufficient areas were enrolled.Serum TSH,FT4,and FT3 were determined by chemiluminescent immunoassay,while antithyroid antibody by radioimmunoassay.The positive rate of thyroid autoantibodies in females was significantly higher than that in the male (5.6％ vs 2.0％ in school children,and 22.8％ vs 3.2％ in adults) ; while positive rate of autoantibodies in pregnant and lactating women (8.9％,8.7％) were significantly lower than that in the other healthy adult women (22.8％).The incidence of abnormal thyroid function in antibody-positive people was higher than that in negative ones in all groups,and abnormal thyroid function showed mainly as subclinical hypothyroidism.In addition,lactating women with negative autoantibodies presented a higher incidence of abnormal thyroid function,mainly as low FT4.The abnormal thyroid function is related with the positive thyroid autoantibodies,indicating that it is essential to follow-up these people with positive antibodies in order to facilitate prevention,early diagnosis,and treatment of thyroid disease.Reference data for thyroid hormones in lactating women should be establisbed as soon as possible.

Objective To construct a genetically-stable double auxotrophic,in which the uracil and leucine were mutated,using the Candida parapolymorpha ATCC26012 as materials.Methods Based on the physical and genetic engineering methods,the chromosome of the C.parapolymorpha strain was modified,where the ura3 and leu2 genes were directly mutated,to obtain the uracil and leucine double auxotrophic strain.Then the constructed strain was identified by the analysis of its biological properties,such as genetic stability,the change of the genes,and the physiologic and biochemical characteristics.Results The uracil and leucine double auxotrophic strain is obtained by screening.The biological identification results show that the obtained strain is genetically stable and the targeted genes are directly altered.In addition,the physiologic and biochemical analyses indicate that the auxotrophic can utilize various kinds of carbon and nitrogen nutrient sources,and its growth is good.Conclusion The successful construction of double auxotrophic mutant strains facilitated the genetic studies on C.parapolymorpha to meet various investigational purposes.Moreover,the constructed auxotrophic strains can be applied as advantageous host cells to express multiple proteins/antigens simultaneously,which is of great significance in the development of vaccines.

Digestive tract reconstruction is an important part of gastric carcinoma operation as well as tumor resection and lymph node dissection.Surgeons are seeking the optimal reconstruction method that reduces the occurrence of complications and maintains better quality of postoperative life extremely.Uncut Roux-en-Y anastomosis is a modified procedure in which an artificial jejunal occlusion is devised to avoid Roux stasis syndrome based on Billroth Ⅱ and Braun's anastomosis.Compared to the conventional Roux-en-Y anastomosis,the uncut Roux-en-Y anastomosis retains the advantage of preventing biliary and pancreatic secretions reflux,furthermore,it can decrease the symptoms associated with Roux stasis owing to the abnormal myoelectrical conduction of Roux limb.Because the early studies indicated that there was higher incidence of dehiscence or recanalization of the jejunal occlusion,the uncut Roux-en-Y anastomosis has not been widely applied.Since jejunal occlusion has been optimized recently,the uncut Roux-en-Y reconstruction may be an optional and appropriate method of digestive tract reconstruction after distal gastrectomy.

Objective To evaluate the immunogenicity of the recombinant human papillomavirus type 68b (HPV68b) virus-like particles(VLPs)in a mouse model.Methods The L1 protein of HPV type 68b was successful expressed in the Hansenula polymorpha strain (NVSI-68b-1).Processes including purifi-cation and reconstitution were performed to achieve pure HPV 68b VLPs.The purity, morphology and immu-nogenicity of the purified HPV 68 b VLPs were further analyzed .The BALB/c mice were immunized with HPV68b VLPs formulated on aluminum adjuvant .Pseudovirus-neutralizing antibody ( PsV NAb) assay was performed to detect the neutralizing antibodies in serum samples .Results The HPV 68 b L1 VLPs were ob-tained as indicated by the results of SDS-PAGE, Western blot assay , HPLC, electron microscopy and dy-namic light scattering with a high purity of 95%.Transmission electron microscopy and dynamic light scat-tering analysis revealed that the HPV68b L1 VLPs resembled the native virus with an average particle diame-ter of 50 nm.High levels of HPV68b-neutralizing antibodies were detected in serum samples from the mice immunized with HPV68b L1 VLPs.Moreover, a cross-protective efficacy of HPV68b L1 VLPs for HPV68a was observed .Conclusion This study suggested that the recombinant HPV 68 b VLPs expressed in a Han-senula polymorpha strain might be used as a potential candidate for the development of HPV vaccine .

BACKGROUND:Orthotopic liver transplantation is the most effective therapy for the treatment of end-stage liver diseases, but the lack of donor source, immune rejection, and repeated infections limit its application. Stem celltransplantation technology provides a new idea for the treatment of end-stage liver diseases. A variety of methods have been confirmed to successful y induce umbilical cord blood mesenchymal stem cells converted into liver cells in vitro.
OBJECTIVE:To explore the clinical efficacy and feasibility of human umbilical cord blood mononuclear cells transplantation in the treatment of decompensated cirrhosis.
METHODS:Twenty-three patients with decompensated cirrhosis received al ogeneic human umbilical cord blood mononuclear celltransplantation. Serum alanine aminotransferase, albumin, cholinesterase, total bilirubin and prothrombin time were detected at post-transplantation weeks 2, 4, 8 and 24. Improvement in clinical signs and symptoms as wel as adverse reactions was observed.
RESULTS AND CONCLUSION:Liver function had no changes at 2 weeks after human umbilical cord blood mononuclear celltransplantation (P>0.05). At 4 weeks after celltransplantation, serum alanine aminotransferase was improved significantly (P<0.05), but the other indexes stil had no changes. Until 12 weeks after celltransplantation, there were significant improvements in al the liver function indicators (P<0.05) and the liver stiffness (P<0.05). By the end of 24 weeks, al the test results were improved significantly (P<0.01). Clinical symptoms were al eviated, including fatigue improvement in 20 cases (87%), improved appetite in 21 cases (91%), and relieved ascites in 19 cases (83%). No severe adverse reactions were found during the transplantation and 24-week fol ow-up. These findings suggest that human umbilical cord blood mononuclear cells transplantation is effective and safe for the treatment of decompensated cirrhosis, which can be considered as a clinical therapy for patients with advanced cirrhosis.

To compare the early-phase secretion between islet α cells and β cells in subjects with normal glucose tolerance and to explore the influencing genetic factors on the function of islet cells.40 subjects with normal glucose tolerance and family history of diabetes ( FH+ ) and 55 healthy volunteers without family diabetes history ( FH ) were collected.Fasting and L-arginine stimulating insulin,glucagon,and tasting free fatty acid,as well as other indicators were determined in all subjects.Insulin resistance was evaluated by homeostasis model assessment for insulin resistance.After adjnsting for sex,age,and body mass index,the insulin secretion peak of the two groups reached both at two min,and began to decline at four min,the peak multiple of FH+group was significantly less than that of FH-group (7.29 vs 8.88,P＜0.05) ; glucagon secretion peak of both groups reached at two min and began to decline by four min.Fasting glucagon and peak multiple were not significantly different (P＞0.05) ; The ratio of fasting insulin to fasting glucagon of the two groups was without significantly difference ( P＞0.05 ).Under diabetes genetic background,the function of β cells decreases even in subjects with normal glucose tolerance.

significant for the precaution of gastric cancer risk population. Aims:To explore gastric cancer susceptibility gene profiling in an area in Shanghai,and to assess the risk of gastric cancer susceptibility. Methods:A total of 152 patients with primary gastric cancer at Shanghai Pudong Hospital were enrolled,and 152 demographic characteristics matched patients with non-gastrointestinal diseases,non-tumor were served as controls. Gene polymorphism was determined by allele specific polymerase chain reaction. Susceptibility gene of gastric cancer was screened. Multiple genes interactions were analyzed and multiple genes risk was evaluated by DEMCHUK model. Results:Univariate analysis showed that CYP2E1,NAT2M1,NAT2M2,NAT2,XRCC1194,MTHFRA1298C,VDR TaqⅠ were susceptibility genes of gastric cancer. Multivariate analysis showed that CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2(A/ A),XRCC1194( T/ T)and MTHFRA1298C(A/ C)were susceptibility genotypes. Synergistic effect was found between genes except MTHFRA1298C (A/ C)with NAT2M1(T/ T)and NAT2M2(A/ A)(P ﹤0. 05). Multiple genes risk analysis showed that combination OR of multiple genes was highly correlated with gene frequency,and the risk of gastric cancer was increased with the increasing number of susceptibility genes. Conclusions:CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2( A/ A),XRCC1194( T/ T) and MTHFRA1298C( A/ C) are susceptibility genotypes of gastric cancer. Carrying multiple susceptibility genes can significantly increase the risk of gastric cancer.

Objective To investigate the nutritional risks, prevalence of undernutrition, and nutritional interventions among inpatients in departments of nephrology in some hospitals in Guangzhou, with an attempt to provide evidences for the nutritional support of patients with kidney diseases. Methods Totally 378 adult patients in departments of nephrology in Guangzhou were enrolled in this study by fix-point consecutive sampling. Nutritional Risk Screening 2002 (NRS 2002) was applied for nutritional risk assessment. Nutrition risk was defined by NRS score ≥3 and undernutrition by BMI ＜ 18.5 kg/m2 or serum albumin ＜ 30 g/L. Nutritional interventions were also evaluated in all patients. The relationship between nutritional risk and nutritional support was analyzed. Results The overall prevalence of undernutrition was 21.7% and the nutritional risk was 41.3%. They were especially high among patients with chronic kidney dysfunction (24. 3% and 60. 7% , respectively). The nutritional risk was 42. 3% in patients accompanied with diabetes (P＞0. 05). Of these 378 patients, 102 (27.0%) received nutritional interventions, in which the nutritional support rate was 50. 0% (78/156) for patients with nutritional risks and 10. 8% (24/222) for those without nutritional risks. Conclusions The nutritional risks and prevalence of undernutrition are high among inpatients in the departments of nephrology in hospitals in Guangzhou. Proper application of nutritional interventions remains a concern. Evidence-based guidelines are required to improve this situation.

Objective To explore the efficacy of multilevel anterior cervical discectomy and fusion for aged patients with cervical spondylotic myelopathy. Methods 25 aged patients with cervical spondylotic myelopathy were treated by multilevel anterior cervical discectomy and fusion. Japanese Orthopedic Association (JOA) scores were evaluated,clinical results were graded from excellent to poor using Odoms criteria,and the sagittal alignment of fusion segements were measured using Cobb method. Bone fusion and complications was evaluated. Results The final follow up score according to Odoms criteria was excellent in 8 patients ,good in 14 patients,and fair in 3 patients ,with excellent and good rate of 88%. The JOA score at final follow up(7.8) was significantly higher than preoperative(12. 8),with average improvement rate of 54%. At final follow up,bone fusion rate was 100%. Conclusion Multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy was effective.