Medullary thyroid carcinoma originates from parafollicular cells. Its prognosis is worse than that of differentiated thyroid carcinoma. Surgery is the best treatment for early stage diseases. In the past decade, dominant activating mutations in the RET pro-oncogene have been identified as the main cause of MTC. Mutation analysis of the RET proto-oncogene has been used in the early diagnosis, prophylactic surgery and targeted therapy of MTC.

As the main force of new drug research and development (R&D) in China,pharmaceutical universities are in charge of developing new drugs with our own intellectual property rights.The concept of translational medicine provides opportunity and challenge to improve the efficiency of new drug R&D.Several translational medicine centers have been set up in pharmaceutical universities,which provide practical conditions for new drug R&D in domestic.Administration management approaches to promote new drug R&D in translational medicine platform are analyzed in the paper.

Objective To study the effect of nebulized inhalation of ipratropium bromide and ambroxol hydrochloride (mucosolvan) on pulmonary function in elderly patients who need thoracotomy.Methods From June 2011 to December 2011,a total of 60 elderly patients undergoing thoracotomy were randomly divided into 2 groups:the treatment group (n =30) and control group (n=30).The patients in treatment group were treated with ipratropium bromide 0.5 mg and mucosolvan 15 mg diluted in 5 ml saline for inhalation with an oxygen flow rate of 6 L/min,15 min,3 times/d,and the patients in control group were treated with ipratropium bromide 0.5 mg diluted in 5 ml saline for inhalation with an oxygen flow rate of 6 L/min,15 min,3 times/d.The resting lung function in patients was measured before nebulization treatment.After 3 days treatment,the resting lung function was measured again,and vital capacity (VC),forced expiratory volume in one second (FEV1),FEV1 ％,maximal voluntary ventilation (MVV) were recorded.Results After 3 days treatment,the indicators of lung function including VC,FEV1,FEV1 ％,MVV were significantly increased in both groups (P＜0.01).The increase in VC,FEV1,FEV1 ％,MVV were significantly higher in the treatment group [(0.39±0.08)L,(0.20±0.10)L,(10.61±4.66)％,(10.24±5.07)L,respectively] than in control group [(0.31±0.05)L,(0.13±0.06)L,(7.40±3.89)％,(6.76±3.70)L,respectively] (t=4.81,3.64,4.13,3.48,all P＜0.05).The incidence of postoperative pulmonary complications was lower in treatment group[16.7 ％ (5/30)] than in control group [30.0 ％ (9/30)] (x2=11.45,P＜0.05).Conclusions The nebulized inhalation of ipratropium bromide and ambroxol hydrochoride can improve the lung function in elderly patients undergoing thoracic surgery,better withstand the thoracotomy and decrease the incidence of postoperative pulmonary complications.

BACKGROUND:Tissue-engineered skin is a new method to cure the massive defects of skin caused by burn or trauma.Therefore, the seed cells and scaffold on the tissue-engineered skin have become the focus today.DATA SOURCES: A computer-based online search of Pubmed database was undertaken to identify the articles about tissue-engineered skin published in English between January 1990 and January 2007 with the key words of "tissue engineered skin, stem cell". Meanwhile, we searched Chinese Journals Full-text Database for related Chinese articles published between January 1994 and January 2007 with the key words of index "tissue engineered skin, skin stem cell" in Chinese.STUDY SELECTION: The data were selected firstly to choose the full-text of articles met the criteria. Inclusive criteria:① Articles about seed cells of tissue engineered skin;②Articles about the scaffold of tissue-engineered skin. Exclusive criteria: Repetitive or analogical articles, Meta analysis or case reports.DATA EXTRACTION: Totally 97 articles on tissue-engineered skin were collected and 69 met the inclusive criteria after eliminated the repetitive or similar studies.DATA SYNTHESIS: The development of tissue engineering provides a new approach for the treatment of massive defects with skin transplantation, and gets rid of some problems such as donor site shortage, immune rejection, disease spread et al.① Skin seed cell: Embryonic stem cell and various adult stem cells can serve as seed cell of tissue-engineered skin, and embryonic stem cell is the first choice, which is transplanted on the biological scaffold to acquire the epidermis, dermis and compound skin.②Research progress of epidermis substitute.③Methods to make dermal substitute.④Research direction of compound artificial skin.⑤There are many problems in wide clinical application of tissue-engineered skin, but more and more attention has been paid on its research.CONCLUSION: Tissue-engineered skin is the best choice to cure the massive defects of skin and has a wide clinical prospect. With the rapid development of life science, operation technology, material science and many other related subjects, the ideal tissue-engineered skin can be obtained with similar function and feature to natural skin.

Objective To investigate the risk factors for ischemic stroke in patients of Aba Tibetan and Qiang Autonomous Prefecture. Methods From March 2012 to March 2014,314 consecutive patients with ischemic stroke admitted to the Department of Neurology,Aba Tibetan and Qiang Autonomous Prefecture People′s Hospital,Sichuan Province were enrolled respectively. All patients were Tibetans. They were divided into either an observation group (n = 105)or a control group (n = 209)according to whether they had high-altitude polycythemia or not. The observation group was the patients with high-altitude polycythemia complicated with ischemic stroke,and the control group was the patients with ischemic stroke without high-altitude polycythemia. The risk factors for onset of stroke in both groups were compared,and the single factor indices with statistical significance were analyzed by multiple logistic regression analysis. Results There were significant differences in hypercholesteremia,history of heavy smoking,and family history of stroke between the observation group and the control group (χ2 values were 6. 489,8. 107,and 11. 206,respectively;P values were 0. 011,0. 004,and 0. 001,respectively). There were no significantly difference in other stroke risk factors between the 2 groups (all P > 0. 05). Multiple logistic regression analysis showed that hypercholesteremia,history of heavy smoking,and family history of stroke were the independent risk factors for high-altitude polycythemia complicated with ischemic stroke (hypercholester-emia:OR,4 . 799 ,95 % CI 1 . 266 - 3 . 148 ,P = 0 . 028;history of heavy smoking:OR,4 . 539 , 95 % CI 1. 061 -4. 182,P =0. 033;family history of stroke:OR,3. 549,95% CI 1. 279 -5. 377,P =0. 008). Conclusions Hypercholesteremia,history of heavy smoking,and family history of stroke,are the independent risk factors for ischemic stroke. The prevention of stroke in the local area should be targeted at the geograph-ical and population characteristics.

Objectives:To investigate the experience in insertion and management of central venous catheter. Methods:132 cases received insertion of central venous catheter.The site of catheter tip was determined with the method of electrocardiograph.The insertion depth was calculated with method of Fujii.The catheter was managed with strictly sterile technique and its lumen was washed with 0.1 mol/L NaOH 2.0 ml. Results:All catheters were inserted smoothly and its tips lay in suitable sites.128 pieces of catheter were pulled out after finished infusion. Conclusions:A right method of insertion and management is in favor for the use of a central venous catheter.

Objective To investigate the clinical value of INSURE technology in very low and extremely low birth weight infants requiring respiratory support.Methods From June 2010 to August 2012,83 cases of very low and extremely low birth weight infants who had difficulty in breathing and required respiratory support were admitted into First Hospital of Tsinghua University and divided into two groups:INSURE group (n=41) and mechanical ventilation (MV) group (n=42).Infants in INSURE group accepted intubate-pulmonary surfactant-extubate to continuous positive airway pressure and those in MV group accepted intubation with or without pulmonary surfactant treatment,and mechanical ventilation without extubation.Arterial blood gases at 1 h and 12 h after treatment were compared between the two groups by t test.The incidence of respiratory distress syndrome,ventilator associated pneumonia,air leaking,chronic lung disease,intracranial hemorrhage,retinopathy,leukoencephalomalacia disease were compared with Chi-square test.Hospitalization costs,duration of ventilation,oxygen inhalation and hospital stay were compared by rank-sum test.Results (1) PO2 in INSURE group after one hour of treatment were (78.7 ±11.5) mm Hg(1 mm Hg=0.133 kPa),which were higher than those before treatment [(50.1 ±10.8) mm Hg,t=9.737,P＜0.05]; while PCO2 was lower[(48.3±8.9) mm Hg vs (54.9±11.5) mm Hg,t=-3.428,P＜0.05].PO2 in MV group after one hour of treatment were (80.2±10.0) mm Hg,which were higher than those before treatment [(51.3±9.8) mm Hg,t=10.093,P＜0.05]; while PCO2 was lower[(45.6±9.5) mm Hg vs (57.1±12.8) mm Hg,t=-4.526,P＜0.05].(2) There were no difference in PO2 and PCO2 between the two groups after one hour of treatment (P＞0.05).After 12 hours of treatment,no differences were found in PO2[(89.4±11.5) mm Hgvs (90.2±10.8) mm Hg,t=0.093] and PCO2[(44.2±5.9) mm Hg vs (39.1± 7.3) mm Hg,t=0.126] between INSURE group and MV group (P＞0.05 respectively).(3) The incidence of ventilator associated pneumonia,air leaking,intracranial hemorrhage and chronic lung disease in INSURE group were 7.3％ (3/41),4.9％ (2/41),4.9％ (2/41) and 4.9％ (2/41),which were lower than those in MV group [34.1％ (14/42),x2=27.470; 16.7％ (7/42),x2=8.651;19.0％ (8/42),x2 =8.814; 11.9％ (5/42),x2 =4.275](P＜0.05 respectively).Duration of ventilation,oxygen inhalation,neonatal intensive care unit stay in INSURE group were 5 d (3-7 d),8 d (5-11 d) and 16 d (11-25 d),which were all shorter than those of MV group [8 d (4-12 d),Z=-1.947; 12 d (8-22 d),Z=-2.013; 21 d (12-35 d),Z=-1.782](P＜0.05 respectively).Conclusions INSURE technology could be used in very low and extremely low birth weight infants because of less invasiveness,fewer complications,safety and low-cost.

Objective To understand the effects of various decoration materials and furniture on indoors air quality. Methods Formaldehyde, benzene and ammonia were monitored in indoor air of some residential buildings in Guangzhou. The residential rooms were divided into two groups, one was simply decorated group, the other was completely decorated group and the two groups were compared. The questionnaire was also carried out. Results The average concentrations of formaldehyde of the two groups were 0.338 mg/m3 and 0.027 mg/m3 respectively, the rates of exceeded standard were 57.14%, 6.67% respectively, and the difference between the two groups was obvious (P

OBJECTIVE: To strengthen the standardized management in dispensary for outpatients,ensure drug quality and medication safety. METHODS: Systemic regulatory system and the operation rules which included the detailed management regulations,work procedure,division of labor of post and management system of different category of drugs etc were established. RESULTS & CONCLUSION: The institutionalization and standardization of the management contributed to the standardization of personnel's behavior,reduction of conflicts between pharmacists and patients,enhancement of patients' trust degree and satisfaction,and the medication safety of patients.

Objective To investigate the early diagnosis of myocardial injury after neonatal asphyxia based on the clinical manifestations of myocardial injury, electrocardiogram (ECG), cardiac enzymes and tissue Doppler echocardiography. Methods From January 1, 2013 to June 30, 2014, 101 cases of neonatal asphyxia in the neonatal intensive care unit of the First Hospital of Tsinghua University, with gestational age> 37 weeks and birth weight > 2 500 g, were enrolled. Apgar scores were used to diagnose neonatal asphyxia. Myocardial damage after neonatal asphyxia was diagnosed according to the hypoxia history, clinical presentation, ECG and cardiac enzymes. According to the umbilical arterial blood gas analysis, severe asphyxia was divided into two groups:the severe asphyxia with severe acidosis group and the severe asphyxia without acidosis group. The incidence of myocardial damage, clinical manifestations associated with myocardial damage, ECG and myocardial enzymes [creatine kinase isoenzyme MB (CK-MB) and cardiac troponin T (TnT); control group involved 50 cases for the same period of admission with newborn jaundice] and echocardiography (control group involved 30 cases for the same period with normal term delivery) were compared among the three groups [mild asphyxia (n=72), severe asphyxia with severe acidosis (n=18) and severe asphyxia without severe acidosis (n=11)]. One-way ANOVA, the LSD test, Kruskal-Wallis test for independent samples, Chi–square test and Fisher's exact test were used for statistical analysis. Results (1) The incidence of myocardial damage after asphyxia was 34.6%(35/101). It was higher in the severe asphyxia group than in the mild asphyxia group [62.1%(18/29) vs 23.6% (17/72), χ2=7.549, P=0.006]; and it was higher in the severe asphyxia with severe acidosis group than in the severe asphyxia without severe acidosis group (14/18 vs 4/11, Fisher's exact test, P=0.048). (2) Clinical manifestations: The proportion of bradycardia was greater in the severe asphyxia with severe acidosis group (13/14) than in the severe asphyxia without severe acidosis group (1/4) and the mild asphyxia group (7/17);the differences were statistically significant (Fisher's exact test, P=0.019 and 0.007). (3) ECG: Eighteen cases (51.4%, 18/35) showed ECG abnormalities. (4) Cardiac enzymes:CK-MB 48 h after birth in the severe asphyxia with severe acidosis group, severe asphyxia without severe acidosis group, mild asphyxia group and the control group were 78.72 (34.63-122.01), 31.71 (21.33-37.12), 23.11 (14.61-36.02) and 11.82 (8.64-18.93) μg/L, respectively. CK-MB in the severe asphyxia with severe acidosis group was higher than in the severe asphyxia without severe acidosis group, mild asphyxia group and the control group (H=48.425, 90.040 and 96.045, respectively, all P<0.01). After treatment for 5-7 days, there was no statistically significant difference in these four groups (H=7.165, P=0.416). TnT 48 h after birth in the four groups was 0.19 (0.12-0.39), 0.11 (0.06-0.34), 0.07 (0.05-0.13) and 0.06 (0.04-0.08) μg/L, respectively. TnT in the severe asphyxia with severe acidosis group was higher than in the other three groups (H=45.753, 44.665 and 61.215, respectively, all P < 0.01). Despite the reduced TnT level after treatment for 5-7 days, TnT in the severe asphyxia with severe acidosis group was higher than that in the other three groups (H=17.520, 21.122 and 43.286, respectively, all P<0.01). (5) Echocardiography:Twenty cases (57.1%, 20/35) showed abnormalities. The values of mitral systolic peak velocity and late diastolic peak velocity in the severe asphyxia with severe acidosis group were lower than those in the control group found by tissue Doppler echocardiography [(3.4±0.3) vs (4.8±0.3) cm/s, (4.1±0.2) vs (6.0±1.1) cm/s, respectively, t=3.293 and 2.542, both P < 0.05]. Conclusions Myocardial damage can occur after neonatal asphyxia. Cord blood pH value should be combined to determine the severity of asphyxia. Myocardial damage is more serious in the severe asphyxia with severe acidosis group. Clinical manifestations should be taken seriously, and laboratory examinations should be improved for early diagnosis and treatment.