Hypoproteinemia Research Articles

Influence of nursing intervention on the complications of early onset severe preeclampsia

Objective To discuss the influence of nursing intervention on the complications of early onset severe preeclampsia.Methods 120 patients with early onset severe preeclampsia from January 2010 to December 2011 were selected and randomly divided into two groups:the control group and the observation group.The control group received conventional treatment and nursing,while the observation group received nursing intervention in addition,and two groups' complications were compared.Results In the observation group,there was one placental abruption case,three hypoproteinemia,no HELLP syndrome,no heart failure,no renal failure,no eclampsia,no maternal death and no neonatal death,and the maternal-infant outcome was good.In the control group,there were 5 placental abruption cases,16 hypoproteinemia,4 HELLP syndrome,3 heart failure,4 renal failure,2 eclampsia,no maternal death but 2 neonatal death caused by severe perinatal asphyxia.The difference of the complications was statistically significant ( P ＜ 0.05 ).Conclusions Nursing intervention for patients with early onset severe preeclampsia is clinically effective to reduce the incidence rate of complications such as placental abruption,eclampsia in hospital,heart failure,renal failure,hypoproteinemia and HELLP syndrome,as well as to improve the life quality of both the patients and the perinatal child. Key words: Eclampsia; Early onset severe preeclampsia; Pregnancy complications; Nursing intervention

Risk factors of complications after laparoseopic gastrectomy: a Logistic analysis

Objective To analyze the risk factors of complications after laparoscopic gastrectomy.Methods The clinical data of 76 patients who received laparoscopic gastrectomy at the Tenth Hospital of Tangji University from April 2009 to July 2011 were retrospectively analyzed.All patients were divided into complication group (13patients) and non-complication group (63 patients).Seventeen variables,including gender,age,abdominal surgery history,comorbidities (cardiovascular disease,chronic obstructive pulmonary disease,diabetes mellitus,anemia,hypoproteinemia,pyloric obstruction),palliative operation,operative data ( operation time,blood loss,method of alimentary tract reconstruction),postoperative TNM staging,vascular or nerve invasion and number of lymph nodes dissected were analyzed by using the univariate and Logistic regression analysis to screen out the risk factors of postoperative complications.All data were analyzed using the t test or chi-square test.Results There were 67 patients received laparoscopic curative gastrectomy and 9 received laparoscopic palliative gastrectomy.Sixty-three patients received distal gastrectomy ( including 49 received Billroth Ⅰ gastrectomy and 14 received Billroth Ⅱ gastrectomy) and 13 patients received total gastrectomy + Roux-en-Y esophagojejunostomy).The mean operation time,blood loss,number of lymph nodes dissected were ( 263 ± 72) minutes,( 200 ± 191 ) ml and 17 ±8,respectively.There were 25 patients in TNM stage Ⅰ,18 in stage Ⅱ,27 in stage Ⅲ and 6 in stage Ⅳ.The incidence of complications was high in the old patients,but there was no effect of gender and age on the incidence of complications ( x2 =0.68,2.32,P ＞ 0.05 ).The operation time of the complication group was longer than that of non-complication group,but no significant difference was observed ( t =1.44,P ＞ 0.05 ).Preoperative comobidities (cardiovascular disease,chronic obstructive pulmonary disease,diabetes mellitus,anemia,hypoproteinemia,pyloric obstruction),blood loss and number of lymph node disseeted were not the risk factors of postoperative complications ( x2 =3.20,0.58,0.13,0.26,0.01,0.19,t =0.15,0.83,P ＞ 0.05).The results of multivariate Logistic regression analysis showed that Billroth Ⅱ alimentary tract reconstruction,more comorbidites,and advanced TNM stage were correlated with postoperative complications ( OR =5.54,7.02,2.33,P ＜0.05 ).The accuracy rate of multivariate Logistic regression analysis was 8 i.6％.Conclusion Billroth Ⅱ alimentary tract reconstruction,more comorbidities,and advanced TNM stage are the independent risk factors of complicatioas after laparoscopic gastrectomy. Key words: Gastric neoplasms; Laparoscopy; Gastrectomy; Complications; Risk factors

Risk factors and antibiotic resistance analysis of pneumonia caused by multidrug resistant acinetobacter baumannii in pediatric intensive care unit

Objective To investigate the risk factors involved in the refractory pneumonia caused by multidrug resistant acinetobacter baumannii (MDRAb) in pediatric Intensive care unit (PICU).Methods From January 2009 to August 2011,115 patients with MDRAb pneumonia were treated in Department of Emergency,Wuhan Children's Hospital,Wuhan.Another 45 patients with negative MDRAb (NMDRAb)pneumonia served as control.The patients in the two goups were analyzed using univariate and multivariate Logistic regression to find out the risk factors for MDRAb infection.Results Among the 176 clinical strains of acinetobacter baumannii isolated,128 (72.73％) strains were MDRAb.After drug susceptibility tests,acinetobacter baumannii showed the rates of resistance to β-lactams antibiotics not including cefoperazone-sulbactam were more than 70％,and the rates of resistance to carbapenems antibiotics were higher than 90％.All rates of resistance to antibiotics of betalactams and carbapenems in MDRAb were higher than those in NMDRAb significantly.There were very low rates of drug-resistance found in Amikacin,Levofloxacin,Ciprofloxacin and Minocycline ( ＜20％ ).Multivariate logistic regression revealed that ICU stay,length of time for mechanical ventilation,anemia,hypoproteinemia and the use of carbapenems were independent risk factors involved in MDRAb pneumonia.Conclusions MDRAb was an important conditional pathogen with high rate of drug-resistance to many antibiotics leading to pneumonia in PICU.It increased the mortality of patients significantly.To control the infection of MDRAb was the key to increasing efficacy of treatment of pneumonia in PCIU. Key words: Pediatric; Intensive care unit; Multidrug resistant; Acinetobacter baumannii; Pneumonia; Risk factor; Retrospective study

Causes and prevention of complications associated with surgeries for gastric cancer in elderly patients

Objective To improve the postoperative survival rate in elderly patients undergoing surgeries for gastric cancer by investigating the causes and prevention of surgery-associated complications.Methods Retrospectively analyzed the clinical data on 178 elderly patients with gastric cancer who had been hospitalized during the period of October 2006 to October 2011 and the effect of 8 factors such as age,gender,preoperative diseases,surgical time and method in the development of postoperative complications.Results The rate of postoperative complications was not obviously associated with age,sex,and tumor locations ( P＞ 0.05 ).Concomitant diseases,surgical duration and procedures,hypoproteinemia,and preoperative values of erythrocyte and hemoglobin were the independent risks of postoperative complications,and their ORvalues were 3.837,3.412,2.782,2.046,and 2.031,respectively.Conclusions Various complications easily occurred in elderly patients with gastric cancer.The incidence of complications is closely associated with some postoperative independent risks.These Patients need to be paid more attention,especially the ones with the 5 factors mentioned above. Key words: Elderly; Gastric cancer; Postoperative complication; Analysis; Prevention and treatment

Mucin phenotypes and macroscopic shape of multiple hyperplastic polyps together with two carcinomas in the stomach.

The patient was a 57-year-old Japanese woman who had been identified as having anemia and hypoproteinemia by a local group medical check-up. Esophagogastroduodenoscopy revealed an elevated lesion of 35mm in diameter on the posterior wall of the gastric antrum, surrounded by multiple polyps. The elevated lesion was diagnosed as an adenocarcinoma on the basis of biopsy, and total gastrectomy was performed. Histological examination of entire resected stomach revealed two lesions of intramucosal carcinoma together with multiple hyperplastic polyps. To investigate the mucin phenotypes and carcinogenesis of these lesions, immunohistochemical analyses of MUC2, MUC5AC, MUC6, CD10, Ki-67 and p53 protein expressions were performed in 17 hyperplastic polyps and two cancerous lesions. Expression of the MUC6 positive glands beneath the surface foveolar epithelium of hyperplastic polyps caused a morphological change from sessile to pedunculated, suggesting that this was also involved with cancerous changes. The case reported herein seems to be extremely interesting in terms of elucidating the process whereby gastric cancer arises from hyperplastic polyps.

Clinical study of 12 cases with obstetric mirror syndrome

To discuss the clinical features, management, pregnancy outcome and prognosis of obstetric mirror syndrome. The clinical data of 12 cases with obstetric mirror syndrome at Shenzhen Maternity and Child Healthcare Hospital from April 2008 to December 2010 were collected to retrospectively analyze the clinical features, management, pregnancy outcome and prognosis. (1) ETIOLOGY: 12 cases with obstetric mirror syndrome included 9 cases of Bart's hydrops fetalis, 2 cases with fetal complicated congenital cardiac anomalies, and 1 case of unknown etiology. (2) Gestational age at diagnosis and at delivery: gestational age at diagnosis ranged from 28 to 36 weeks [mean (31.5 ± 4.7) weeks], and gestational age at delivery ranged from 28(+3) to 38 weeks [mean (32.9 ± 2.9) weeks]. There were no significant differences between the gestational age at diagnosis and at delivery in consistence with severe preeclampsia group and mild preeclampsia group [(31.8 ± 2.3) weeks vs. (30.9 ± 7.2) weeks, (32.5 ± 2.3) weeks vs. (33.5 ± 3.9) weeks, P > 0.05]. (3) The patients with obstetric mirror syndrome can present a preeclampsia-like syndrome: maternal extremity edema in 12 cases, headache and visual disturbance in 1 case, proteinuria in 11 cases, elevated blood pressure in 5 cases, elevated uric acid in 9 cases, hypoproteinemia in 12 cases, elevated creatinine in 3 case, elevated liver enzyme in 1 case, thrombocytopenia in 2 cases. The major complications included 1 case of HELLP syndrome, acute pulmonary edema, placental abruption, amnionic fluid embolism, DIC respectively, 3 cases of acute kidney failure and 6 cases of postpartum hemorrhage. (4) Sonographic findings: 1) Hydrops fetalis: fetal ultrasound revealed pleural fluid, fetal ascites, skin edema, scalp edema, encephalocolele enlargement, hydropericardium and increased cardio-chest ratio. 2) Placenta megaly: the placental pathological examination revealed edematous and large in 12 cases. Placental thickness was beyond 4 cm in all cases [(6.3 ± 1.9) cm]. 3) Hydramnios: hydramnios could be found in 11 cases [amniotic fluid index (19.7 ± 3.1) cm]. (5) Postnatal conditions:all blood pressure and laboratory findings including urine protein normalized within 5 to 7 days after delivery. (6) Pregnancy outcome:all 12 patients survived, however the perinatal mortality rate was 100%. Two of 12 cases with mirror syndrome underwent cesarean section, and 10 were vaginal delivery, of which 1 need uterine artery embolisom due to postpartum hemorrhage. Obstetric mirror syndrome seems to simulate preeclampsia although there are distinguishing features, such as hemodilution, placental edema, and polyhydramnios. When the specific cause of obstetric mirror syndrome can not be identified and corrected, the decision for delivery should be made as soon as possibly.

Serum total calcium, ionised calcium and corrected total calcium concentrations in Kwashiorkor and nephrotic syndrome patients : peer reviewed original article

Calcium in blood plasma circulates in two main states: The non-diffusible protein-bound calcium which constitutes approximately 45% of the total plasma calcium and the diffusible free calcium fraction which can be further subdivided into complexed calcium and ionised calcium. The ionised calcium fraction is the physiologically active form. Albumin is the protein, which binds approximately 80% of the protein-bound calcium fraction in plasma, therefore any changes in plasma albumin concentration will directly influence the plasma total calcium concentration. To demonstrate this hypothesis, a study was done on patients with decreased plasma albumin concentrations to determine the effect on their total calcium, ionised calcium and corrected total calcium concentrations. Our study clearly illustrates that ionised calcium and corrected total calcium concentrations are better indicators of calcium homeostasis in patients with hypoproteinaemia, than total calcium concentrations alone. Medical staff therefore, cannot only rely on total calcium concentrations in these patients.

Analysis of intrinsic risk factors of the postoperative infection in patients with recurrent intracranial neoplasm

Objective To clarify the intrinsic risk factors contributing to postoperative infection in patients with recurrent brain tumor. Methods The clinical characteristics of patients with recurrent intracranial neoplasm were collected and analysed retrospectively. The intrinsic risk factors for postoperative intracranial infection were evaluated by χ2 test. The multivariate Logistic regression analysis was employed to select the independent variables associated with postoperative intracranial infection. Results Tumor size, long-term bed, preoperative extracranial infection, diabetes, malnutrition, anemia, hypoproteinemia, organ dysfunction and autoimmune disease had significant effect on postoperative infection, which revealed by the univariate analysis. Multivariate analysis showed that tumor size, preoperative extracranial infection and diabetes contributed to postoperative intracranial infection as independent risk factors. Conclusion Tumor size (diameter > 5 cm), preoperative extracranial infection and diabetes are potential predictors of high risk for postoperative intracranial infection. Efforts should be made to control the factors mentioned above in order to minimize the probability of postoperative infection in patients with recurrent intracranial neoplasm. DOI:10.3969/j.issn.1672-6731.2011.04.016

Advances in pathogenesis research of hypoproteinemia in infectious diseases

Hypoproteinemia is a common clinical complication in many diseases, which could affect the disease prognosis, particularly in critical illness. Low serum albumin level often precludes dangerous conditions and poor prognosis. In the pediatric clinical practice, hypoalbuminemia is commonly seen in acute infection. Therefore, the mechanism of infection-induced hypoalbuminemia should be emphasized, which plays a crucial role in modifying clinical interventions and reducing the mortality rate. But the mechanism of hypoalbuminemia has not yet been fully clarified at present. In this article,the possible mechanism of infectioninduced hypoproteinemia is investigated from the albumin catabolism, synthesis, distribution of abnormalities,half-life, protein-losing enteropathy and so on. Key words: Hypoproteinemia; Infectious diseases; Pathogenesis

Risk factors and drug resistance of enterobacter cloacae infection in ICU

Objective To study the antimicrobial susceptiblity,clinical and bacteriological characteristics of enterobacter cloacae infection in ICU. Methods 83 cases of ICU infected with enterobacter cloacae were analyzed retrospectively. Results The elderly, hypoproteinemia,invasive operation,long-term hospitalization and the abuse of broad-spectrum antibiotics were the risk factors of infection with enterobacter cloacae. Besides highly sensitive to imipenem, the bacterium was resistant to most antibiotics, many of whose drug resistance ratio is over 50%. Conclusion The patients in ICU should be avoided the long-term abuse of broad-spectrum antibiotics and invasive operation.Bacterial culture and antibiotic susceptibility test should be carried out promptly. They could reduce the incidence of enterobacter cloacae infection. Key words: Enterobacter cloacae; Drug resistance; Risk factor

Effects of a Dan Shen component, magnesium lithospermate B, in nephrectomized rats.

Magnesium lithospermate B, a compound newly isolated from Dan Shen, was given orally to rats for 70 days after excision of five-sixths of their kidney volume. As a result, mesangial proliferation, tubulo-interstitial lesions and glomerular sclerotic lesions, which were conspicuous in rats that were not given magnesium lithospermate B after nephrectomy, were inhibited. Furthermore, a decrease in blood urea nitrogen, improvement of hypoproteinemia, hypoalbuminemia and hypercholesteremia, and inhibition of urinary protein excretion were observed. The levels of creatinine, methylguanidine and guanidino-succinic acid, which accumulate in the blood with the progress of renal failure, were decreased significantly in rats given magnesium lithospermate B. These results indicate that magnesium lithospermate B, a component of an Oriental medicine has potential as a new therapeutic agent for inhibiting the progression of renal dysfunction.

Meta analysis of 95 patients with Ménétrier disease in China

Objective To summarize the clinical features, diagnosis and treatment of Menetrier disease in China. Methods A systematic review of Menetrier disease in China was performed. Four electronic databases were searched from 1993 to 2008 including CNKI and Wanfang seeking studies about pathologically performed Menetrier disease. Results Data of 95 patients with Menetrier disease from 62 studies was included. There were 74 males and 21 females. The mean age of onset in adults was （47.4±5. 3） years . The process of the disease was longer in male individuals that in female individals （47.5 months vs. 13.7 months, P〈0.05）. The main symptoms included abdominal pain （76.8%）, weight loss （42.1%）, anorexia （40.0%） and edema of lower extremities （36.8%）, etc. Hypoproteinemia was accounted for 71.6% and most of the patients had hypochlorhydria. The typical giant hyperplastic gastric fold was found in 88.4% of the patients under endoscopy. The diffuse type was in predominance and mainly involved the greater curve of the stomach （55.3%）. Whereas 5.3%patients were accompanied with gastric cancer. The misdiagnostic rate of the disease was 31. 6%, which accounted for 50% in surgically treated patients. Conclusions In China, the Menetrier disease is predominant in middle-aged males, and the process is longer in males than in females. Misdiagnosis is related to existence of weight loss and hypoproteinemia. Most of the patients with Menetrier disease have a good prognosis even the disease process is long. Key words: Gastritis, hypertrophy; Menetrier disease; Disease attributes

Analysis of 32 triplets pregnancies during 10 years

Objective To study the clinical features of triplet pregnancies and the factors influencing the pregnancy outcomes in order to improve the perinatal care and prevent the complications. Methods We retrospectively analyzed the maternal and neonatal complications of 198 pregnancies (32 triplets, 68 twins and 89 singleton pregnancies, with matched gestational age at delivery) that delivered after 28 weeks in our hospital from Jan. 1997 to Dec. 2006. All 32 triplets delivered between 28-37 weeks. Results The incidence of triplet pregnancies in the former 5 years (0. 05%) were similar to the later 5 years (0. 07%), P>0. 05. The rates of hypertensive disorders complicating pregnancy, hypoproteinemia and anemia in the triplets were significantly higher than in the twins and singletons (P 0. 05). The cesarean section rate of the triplets and the twins were 90. 6% and 91.2% ,which were significantly higher than that of the singletons (48. 3% ), P<0. 01. The neonatal mortality rate and the incidence of neonatal respiratory distress syndrome and intracranial hemorrhage were significantly higher in the vaginal delivered babies than those of the cesarean section delivered ones in triplets (70. 6% vs 3/7, 4. 7% vs 3/7, 11.8% vs 3/7, P<0. 01 or 0. 05). Condusions Triplets pregnancies will have more maternal complications than twins and singletons without reduction of the neonatal complications and perinatal mortality rate. Preterm birth may be the main reason for the adverse outcomes in the triplets. Cesarean section can be the first choice for triplets delivery. Key words: Triplet pregnancy; Complication; Perinatal mortality

Assessment of nutrition in the sepsis children

Objective To investigate the severity of infection which is related with serum albumin,cytokines(IL-6、IL-8 and TNF-α)and the concentration of amino acids,it can be helpful to early find malnutrition in sepsis children and provide theories for nutrition support.Methods This prospective study was performed on hospitalized children who were classified as sepsis group(n = 52)and severe sepsis group(n =41).Control group included 300 healthy children.The serum albumin,cytokines(IL-6,IL-8 and TNF-α)and the concentration of amino acids in different groups were measured before the nutrition support.Results Severe sepsis group were all with hypoproteinemia.The concentration of IL-6,IL-8 and TNF-α in severe sepsis group was(193.95±74.11)ng/L、(481.33±186.58)ng/L、(21.00±9.43)ng/L respectively,which were significantly higher than those of sepsis group and control group(P ＜0.01).The concentration of aspartic acid,argine and glycine in severe sepsis group was(23.6±8.5)μmol/L、(6.1±4.7)μmol/L、(101.4± 60.6)μmol/L respectively,which were significantly lower than those of sepsis group and control group(P ＜ 0.01).Conclusion The concentration of aspartic acid,argine and glycine which influence immunologic responses was significantly lower in severe sepsis group with hypoproteinemia,so early nutritional support can improve clirtical outcome. Key words: Sepsis; Amino acid; Cytokines; Nutritional support

The prognosis factors on Severe community acquired Pneumonia of which the pathogens are clear

Objective To investigate the prognosis factors on SCAP patients which are sensitive to the antibiotics.Methods According to the diagnosis standard of SCAP in 2006，45 SCAP patients in our hospital from july 2004 to December 2008 were analyzed retrospectively，of which the pathogens are sensitive to the antibiotics.Results The mortality risk of using the third generation cephalosporins plus macrolides was higher than that of others；The number of the samples with hypoproteinemia in death group is larger than that of survival group；The mortality rate of alcoholism combined concomitant disease group and simple alcoholism group are both higher than that of others.Conclusion To improve the prognosis of SCAP patients，we should eliminate the interfered factors positively，and we shall emphasize primary prevention of the factors. Key words: Pneumonia; Community-acquired; Severe; Prognosis; Influencing factors

Guardianship of patients with multiple organ dysfunction syndrome and hypoproteinemia in ICU

Objective To investigate the prognosis and method of guardianship of patients with multiple organ dysfunction syndrome (MODS) and hypoproteinemia. Methods 90 MODS patients were monitored and their levels of serum albumin were tested. Results The incidence rate of low serum albumin in patients with MODS was about 73.33% (66/90) and the mortality rate in patients with low serum albumin was 50% (33/66), which was obviously higher than that of patients without low serum albumin (25% , P<0.05) . Conclusions It is very important to carry on the serum albumin monitoring in critical patients as early as possible. Key words: Multiple organ dysfunction syndrome; Hypoproteinemia; Monitoring

Early warning signs of severe preeclampsia

To identify the early warning signs of severe preeclampsia (SPE). A case-control (1:2) observational study was conducted. Forty-seven pregnant women with SPE, who attended the prenatal clinics of Peking University Third Hospital regularly from Jan. 2002 to Dec. 2007, were selected as the study group, including 12 early onset and 35 late onset ones. The control group consisted of 94 healthy singleton pregnant women at the same period. Clinical data were collected and analyzed. (1) The basal body mass index (BMI) showed no difference between the study and control group [(23.27 +/- 4.31) kg/m(2) vs (21.52 +/- 3.09) kg/m(2), P > 0.05]. (2) The net increase of BMI in the study group before the onset of SPE was higher than that in the control [(5.60 +/- 2.17) kg/m(2) vs (4.85 +/- 1.52) kg/m(2), P < 0.05] and the increase of BMI per week was also higher [(0.74 +/- 0.41) kg/(m(2).w)(-1) vs (0.23 +/- 0.18) kg/(m(2).w)(-1), P < 0.01]. The sensitivity and specificity of BMI increase per week in predicting SPE was 84% and 81% at a cut-off value of 0.39 kg/(m(2).w)(-1), respectively, and 79% and 91% at 0.41 kg/(m(2).w)(-1) correspondingly. (3) During the third trimester and before the onset of SPE, the weight gain per week in the study group was higher than that of the control [(0.93 +/- 0.70) kg vs (0.63 +/- 0.20) kg, P < 0.01]. Significant difference was also found in the net weight gain between the two groups (P < 0.01), but not in the percentage of women with excessive weight gain (> 0.50 kg/w) [60% (25/42) in the study group vs 63% (53/84) in the control group, P > 0.05]. (4) Higher percentage of women experienced pre-hypertension in the study group than in the controls [17% (8/47) vs 5% (5/94), P < 0.01]. (5) In the study group, 53% (25/47) of the women had edema before SPE onset, but the figure dropped to 18% (17/94) in the controls (P < 0.01). (6) Eight women in the study group and one in the control group suffered from hypoproteinemia before SPE onset with the average level of plasma albumin of (32.6 +/- 1.6) g/L and (38.4 +/- 2.1) g/L (P < 0.01), respectively. (7) Proteinuria was reported in 10 cases (21%) in the study group and 4 (4%) in the controls (P < 0.01). (8) Logistic regression analysis showed that the risk factors for SPE included edema (OR = 6.16, 95%CI: 2.29 - 16.57), pre-hypertension (OR = 6.21, 95%CI: 1.56 - 24.77), proteinuria (OR = 9.68, 95%CI: 1.86 - 50.30), and weight gain > 0.85 kg/w during the third trimester (OR = 11.60, 95%CI: 3.54 - 37.97). Edema, excessive weight gain, pre-hypertension and hypoproteinemia are early warning signs of SPE. Pregnant women with the above signs required close monitoring during prenatal care.

Clinical characteristics and timing of delivery in women with severe preeclampsia complicated with ascites

Objective To investigate the clinical characteristics and the optimal time of delivery in pregnant women with severe preeclampsia complicated with ascites. Methods A retrospective study was conducted on 179 severe preeclampsia mothers and their 195 neonates, presented in the First Affiliated Hospital of Wenzhou Medical College from Jan. 2003 to Dec. 2005, who were divided into two groups： 32 complicated with ascites （aseites group） and 147 without （non-ascites group）. The general conditions, mode of delivery and complications including eclampsia, hemolysis, elevated serum level of liver enzymes, and low platelets （HELLP syndrome）, liver failure, renal failure, heart failure, hypoproteinemia, placental abruption, postpartum hemorrhage and puerperal infection, were also analyzed. Clinical data of all infants （38 from aseites group and 157 from non-aseites group） were analyzed. The incidence and mortality rate of small for gestational age （SGA） in both group within the same gestational age group and those between different gestational age groups in the ascites group were compared. Results （1） The average gestations at admission and delivery in the ascites group were earlier than the other [admission： （32.5±2.1）weeks vs （36.1±3.5）weeks; delivery： （34.1±2.3） weeks vs （37.2±1.5）weeks, P〈0.05]. The rate of systemic antenatal care in the ascites group was lower than that of the non-ascites group （25.0% vs 53.7%, P〈0. 05）. More complications were found in the ascites group than in the non-ascites group （hypoproteinemia： 100.0%vs 47.0% ;liver and renal failure： 31.2% vs 8.2%; HELLP syndrome： 9.4% vs 2.0%; postpartum hemorrhage： 18.8% vs 2.0% ; all P〈0.05）. （2） The incidence of SGA in the ascites group was all higher than that in the non-ascites group, however, significant differences was only found between the two groups at 〉36 weeks （7/9 vs 30.2%, P〈0.05）. The perinatal mortality rates of SGA in the ascites group at 〈32 weeks and 32-34 weeks were significantly higher than that in the non-ascites group respectively （〈32 weeks： 69.2% vs 19.2%, P〈0.05; 32-34 weeks： 2/7 vs 0, P〈0.05）. （3） The highest perinatal mortality rate and the highest incidence of SGA in the ascites group were found in the groups of 〈32 weeks and 〉36 weeks, respectively. Conclusions The early onset of ascites and higher rate of complications in severe preeclamptic women implies the adverse maternal and fetal outcomes. Ascites in severe preeclampsia cases should alert the clinicians. The optimal time for delivery might be at 32-36 weeks of gestations. Key words: Pre-eclampsia; Ascites; Retrospective studies

Chinese-Medicine based body constitution characteristics in the 414 cases of chronic kidney disease

Objective To explore the relationship between the Traditional Chinese Medical characteristics of body constitution and chronic kidney disease. Methods According to the theory of Traditional Chinese Medicine and clinical practice, the body constitutions of chronic kidney disease are divided into nine groups, namely the constitution of balance, deficiency of Qi, deficiency of Yang, deficiency of yin, phlegm-dampness, dampness-heat, blood stasis, stagnation of qi, and specialty. Results From the study of 414 cases of chronic kidney diseases, the paper showed that the cases are great different in Chinese medicine based body constitutions, among them most being deficiency Qi, deficiency of Yin, and defi-ciency of Yang in 25.6%, 22.7%, 16.90%, respectively. Conclusions There is a close relationship between the albuminuria and hematuria in the cases of deficiency Qi. Large number of albuminuria and hypoproteinemia and hyperlipemia are related to the deficiency of Yang. The changes of those indices will worsen the chronic kidney diseases, indicating an inherent relationship of deficient Qi and Yin and Yang to the onset and development of chronic kidney diseases. Key words: Chronic kidney disease; Body constitution of TCM: Character-istics

Clinical analysis of pulmonary tuberculosis with candida albicans infection in 86 cases

Objective To analyze the merger candida albicans pulmonary tuberculosis irfection risk factors, clinical characteristics,treatment and prognosis,ways of improving the coexistence of the two diseases in the early di-agnosis and treatment methods. Methods 86 cases with pulmonary tuberculosis combined candida albicans infection were analyzed. Results Pulmonary lung infection candida albicans no specific clinical manifestations, in addition to X-ray signs of tuberculosis,mainly for the merger under the shadow of lung flake fuzzy; prediction for risk factors: long-term use of broad-spectrum antibiotics, the multi-antibiotics, glucocorticoid or immunosuppreasanta, long-term bed rest, physical weakness, the length of hospitalization, chronic bronchitis and obstructive pulmonary disease (COPD), respiratory failure, mechanical ventilation, diabetes, hypoproteinemia, blood diseases, multiple organ failure,mechanical ventilation,and other invasive operation is closely related to a higher mortality rate of pulmonary fungal infections. Conclusion Active tuberculosis disease and therapy to reduce risk factors, prevention and early diagnosis of good,reasonable use of antibiotics,hormones,and so un,the key is to improve the cure rate. Key words: Tuberculosis, pulmonary; Candida albicans; Infection