Objective To investigate the nursing points and the effect of the conjoint liver and kindey transplantation. Methods To review the concreted nursing experience among 13 patients who have accepted the conjoint liver and kidney transplantation from 1996 to 2004 in the First Affiliated Hospital of Sun Yat-Sen University,and then summarized the nursing key points of the operation. Results All the nursing measures during the course of operation were properly,the means time of operation was 9.5 hours,the means time of liverless was 65 minutes,the blood loss volume was 7 000 ml. Conclusion The nursing key points of conjoint liver and kidney transplantation include sufficient nursing prepare,homoiothermism during the operation,proper using drugs, proper blood-transfusion and fluid infusion.

Objective To discuss the treatment experience of adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The clinical data of 24 cases of AIMAH from August 1972 to December 2016 were retrospectively analyzed.The cases included 10 males and 14 females with a mean age of 43 (range 26 to 59) years.16 patients presented with typical Cushing syndrome (CS) and 8 patients had weight gain, hypertension or diabetes mellitus without any sign of CS.The circadian rhythm of serum cortisol was abnormal.Low and high dose dexamethasone suppression tests failed to suppress cortisol secretion.The preoperative CT scan showed bilateral enlargement of the adrenal glands with multiple macmnodules.14 patients underwent open surgery, including 5 cases of unilateral adrenalectomy, 6 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 3 cases of bilateral adrenalectomy simuhaneously.6 patients underwent conventional laparoscopic adrenalectomy,including 2 cases of unilateral adrenalectomy, 2 cases of adrenalectomy combined with contralateral subtotal adrenalectomy and 2 cases of bilateral adrenalectomy.4 patients underwent robot-assisted laparoscopic bilateral adrenalectomy.Results The postoperative pathological examination showed that all patients had bilateral adrenal macronodular or adenomatoid hyperplasia.During the mean follow-up of 68 months (range 3 to 192 months), the clinical symptoms of CS disappeared after surgery in all cases.7 patients who received unilateral adrenalectomy had urinary free cortisol and serum cortisol within normal ranges and no further enlargement of the contralateral gland was noticed.Among the 3 patients who received bilateral adrenalectomy simultaneously, 1 case died of adrenal crisis on the seventh day post-operation.The remaining 2 cases presented with adrenal insufficiency but returned to normal after glucocorticoid replacement therapy.Nelson's syndrome was not observed in other patients.Conclusions The use of bilateral adrenalectomy to treat AIMAH may involve risk.Unilateral adrenalectomy is recommended for an alternative treatment for AIMAH.Controlateral adrenalectomy with lifelong corticosteroid replacement or contralateral subtotal adrenalectomy may be performed if the symptoms have not improved or recurred after unilateral adrenalectomy.

Objective:To investigate the use of the reference intervals for blood cell counting and the reference of industry standard in China.Methods:Information from all laboratories was collected using online questionnaire in 18 reference intervals survey in blood cell counting in 2019. The information includes the source of the reference intervals, the verification of the reference intervals, and the upper and lower limits of the reference intervals, the method used, the instrument, the reagent and the calibrator. Microsoft Excel 2007 software was used to analyze the results of all laboratories. The median and 95% confidence interval were calculated. The distribution of the reference intervals for blood cell counting and their conformance to industry standards were analyzed.Results:2, 869 labs reported the data. The main sources were industry standards and National Guide to Clinical Laboratory Procedures. The proportion was 33.30%-35.02% and 28.55%-30.90% respectively. 49.44%-55.13% of laboratories validated the reference interval when citing industry standards. The reference interval grouping of most laboratories (89.37%-91.69%) cited in RBC, Hgb and Hct were consistent with the industry standards. We compared the upper and lower limits of the reference intervals with that given by the industry standards, when the lower limit of the reference intervals of mean corpuscular hemoglobin concentration, absolute neutrophils count, absolute basophils count, absolute monocyte count, and lymphocyte percentage were compared. The upper limit of reference intervals of neutrophils percentage as well as upper and lower limits of reference intervals of mean corpuscular volume, mean corpuscular hemoglobin, absolute eosinophil count, basophils percentage, and monocyte percentage were also compared. The median and mode were equal and consistent with industry standards. For other labs, the upper and lower limits of the reference intervals were not consistent with the reference intervals given by the industry standards.Conclusion:The use of reference intervals for blood cell counting was not the same, and the implementation of industry standards was not optimistic. A considerable number of laboratories had not verified the reference intervals, so it was necessary to promote the industry standards for reference intervals.

Objective:To design the small ubiquitin modification-fibroblast growth factor receptor 4 (SUMO-FGFR4) fusion gene and construct the expression vector pET22b-SUMO-FGFR4, to optimize the expression conditions. Methods:The SUMO-FGFR4 fusion gene was obtained by Overlap PCR and was connected to pET22b;the recombinant expression vector pET22b-SUMO-FGFR4 was obtained. The influence of lactose concentration, induction time,induction temperature,induction point and adding mode of lactose in the expression levels was observed,and the best induction condition was determined; then the solubility of recombinant protein was analyzed.Results:The SUMO-FGFR4 fusion protein was highly expressed,the molecular weight of the fusion protein was about 40 000 and it could bind with FGFR4 specific antibody.When the lactose concentration was 1.0 g·L-1 ,the induction time was 3 h,the induction temperature was 37℃,the value of A (600)was 0.8,the expression level was highest;but adding mode of lactose had no remarkable effect on the protein expression.The expression level of recombinant protein induced by lactose was higher than IPTG.SUMO-FGFR4 protein existed in a form of inclusion body.Conclusion:The SUMO-FGFR4 fusion protein is expressed successfully in this study while lactose is used as inducer and the best expression conditions are confirmed.

Objective:To evaluate the effect of internal distraction osteogenesis in the treatment of complicated teeth-maxillofacial deformity.Methods:Clinical data of 1 0 cases with complicated teeth-maxillofacial deformity were analyzed retrospectively.In the first stage,the patients were operated by internal distraction osteogenesis.In the second stage,the distractor was removed after 3 to 6 months of consolidation period,followed by other operation for further occlusal reconstruction.Results:All the operations were per-formed as planned.The distraction distance was 7 -70 mm.The distraction process was smooth in all the cases.Occlusion was recon-structed and the deformity was corrected by following operation satisfactorily.Conclusion:Internal distraction osteogenesis is effective in the treatment of complicated teeth-maxillofacial deformity for further occlusal reconstruction and functional repair.

BACKGROUND:The principle of lyophilization is to sublimate the solvent of frozen materials in vacuum and retain the solute, thus making a pore structure. OBJECTIVE: To produce a chitosan tubular scaffold by lyophilization, and to test its physicochemical properties. METHODS: The chitosan tubular material was prepared by lyophilization method, folowed by gross observation and electron microscopic observation. The chitosan tubular material samples were placed into PBS solution and pure water for 50 days, respectively, and then immersed in trypsin liquid for 1 day folowed by embedded into the muscle and dorsal skin of neonatal Sprague-Dawley rats for 30 days. The degradation rate and porosity of the material were observed and calculated. The breaking strength and compressive strength of the material were determined both under drying and soaking conditions using tensile instrument and pressure meter, respectively. RESULTS AND CONCLUSION:The external form of the chitosan tubular material was normaly tubular. Under the electron microscope, it was composited by different size pores, and the pore size was 50-200μm. The degradation rates of the material were (5.33±0.12)% in PBS, (11.26±0.15) in water, 0.012% in the trypsin liquid and (35.2±3.7)in vivo. The porosity rate was (97.5±1.5)%. The breaking strength and compressive strength of the material was higher under the drying state than under the soaking state (P < 0.05). These findings indicate that the lyophilization method can produce the chitosan tubular material with good porosity rate and degradation rate as wel as good tensile ability and compressive capability.

Objective To explore the effect of the self-designed cotton-padded covering for a modified lithotomy position on preventing complications in the lower limbs in patients undergoing gynecological laparscopic surgery.Methods A total of 320 patients undergoing radical hysterectomy or deep invasive endometriosis were selected and randomly divided into an observation group(n=160) and a control group(n=160).The patients in the control group were placed on the routine lithotomy position,the lower extremity and popliteal space protected with oasis outline cushion in the control group,while the patients in the observation group were placed on the same pads,the lower extremity and popliteal space protected with the self-designed cotton-padded coverings.Results The average temperature of the lower limbs of patients after operation in the observation group was significantly higher than that in the control group (P<0.01).The incidences of complications in the observation group were significantly lower than those in the control group(all P<0.05). Conclusion The self-designed cotton-padded covering for modified lithotomy position can effectively prevent the complications of the lower limbs and improve the comfort of patients.

Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Cirrhosis ; diagnosis ; drug therapy ; Phytotherapy

OBJECTIVE:To observe the activity of Pyrazinamide gel against Mycob ac terium tuberculosis in vitro and its security in bronchial interventional therap y METHODS:The MIC and MBC of Pyrazinamide and Pyrazinamide gel were measured b y handwork method and instrument method and secuity of Pyrazinamide gel was asse ssed by bronchial interventional therapy in rabbits RESULTS:The MICs of pyrazi namide gel to M tuberculosis H37 RV,M bovis and M phlei were 1mg/L,1mg/L,1 0mg/L,the MBCs of Pyrazinamide gel to M tuberculosis H37RV,M bovis and M ph lei were 10mg/L,10mg/L,40mg/L respectively;the MIC and MBC of Pyrazinamide gel and those of Pyrazinamide had no significant differences;the animal security ex periment was negative CONCLUSION:These results suggest that Pyrazinamide gel a nd Pyrazinamide have the same efficacy against M tuberculosis,because carbomer dose not affect the activity of Pyrazinamide against M tuberculosis;Pyrazinami de gel which contains carbomer is safe in bronchial interventional therapy

Objective To propose a new diagnostic criterion for rosacea based on the analysis of clinical features of rosacea in a large sample.Methods A total of 1 090 Chinese outpatients with rosacea were enrolled from Department of Dermatology of Xiangya Hospital,and their demographic data,clinical manifestations and subjective symptoms were collected.According to results of descriptive analysis,clinical features of rosacea were summarized,and a new diagnostic criterion for rosacea was set up.Then,the sensitivity and specificity of the new diagnostic criterion were verified among 1 200 outpatients clinically characterized by facial erythema.Results Of 1 090 patients with rosacea,131 (12.0％) were male and 959(88.0％) were female,and the average age was 33.5 ± 11.1 years (range,10-66).Among the 1 090 patients,715 (65.6％) had initial lesions on the cheek,of whom,712 (99.6％) had intermittent flushing as the initial symptom,and 689 (96％) had sensitive skin symptoms such as dryness,burning and itching sensations;208 (19.1％) had initial lesions on the perioral region,of whom,204 (98.1％) had persistent erythema as the initial symptom;167 (15.3％) had initial lesions on the nose,of whom,163 (97.6％) had persistent erythema as the initial symptom;in addition,311 (28.5％) had lesions on the ocular region,and only 24 (2.2％) had lesions outside the face on the neck and retroauricular region.Based on these clinical features,a new diagnostic criterion for rosacea was proposed,including 1 major condition (intermittent flushing or persistent erythema on the cheek,perioral region or nose) and 5 minor conditions (1.sensitive skin symptoms such as burning,tingling,drying or itching sensations;2.telangiectasia;3.papules or pustules;4.hypertrophy;5.ocular symptoms).If with the major condition and at least one minor condition were met,patients could be diagnosed with rosacea.After verification among 1 200 patients with facial dermatitis clinically characterized by facial erythema,the new criterion was proved to have a sensitivity of 99.3％ and a specificity of 95.8％.Conclusion A new diagnostic criterion for rosacea with high sensitivity and specificity is proposed,which is worthy of clinical application.