Objective To research the clinical value of serum thyroid peroxidase (TPOAb) in screening thyroid dysfunction in pregnancy.Methods The concentration of serum TPOAb and TSH(thyroid-stimulating hormone) was detected by MEIA and CMIA in 75 cases of pregnant women with thyroid disfunction,and 145 cases of pregnant women without tyhroid dysfunction (as control group).Results There were significant differences in both TSH and TPOAb levels between pregnant women with and without thyroid dysfunction(P0.05). So the normal serum TSH could not completely exclude the thyroid dysfunction in pregnant women.Conclusion TPOAb can be used as a prenatal screening marker for early diagnosis of thyroid dysfunction in pregnancy. From the diagnostic point, TSH can not completely substitute for TPOAb and the abnormal TPOAb can indicate the possibility and risk for autoimmune thyroid disease in pregnant women.

Objective In order to avoid potential injuries imposed to human body,it could be feasible to use the musculoskeletal models which can be reconstructed from the cadaver color cryosection(CCC)images,computerized tomography(CT)images,magnetic resonance(MR)images or other images to analyze the dynamic properties of muscles in vivo during human movement.Mothod We reconstruct the lower limb musculoskeletal model and define the uniform ioint coordinate system(JCS)on the model and the subject.The coordinate transformation of the muscle attachment points both on the model and the subject is described in detail.Results The length and the moment arm of the biceps femoris(short head)during knee flexion are calculated and analyzed.Conclusion This method plays an important role in improving the kinematics and dynamic simulation and the muscle force estimation.

Objective:To explore the characteristics of Traditional Chinese Medicine (TCM) syndromes in sepsis patients with different blood urea nitrogen (BUN) levels.Methods:From January 2017 to December 2018, 252 sepsis patients, who were admitted in the Department of Intensive Care Unit of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine) and met the inclusion criteria, were divided into lower level group (BUN<9.25 mmol/L) and higher level group (BUN≥9.25 mmol/L) according to BUN levels. The baseline data, complications, infection sites and other data were collected. TCM syndromes were judged according to the four diagnostic information of TCM and BUN levels. Variables with P<0.2 in univariate analysis were introduced as candidate variables, and the correlation between TCM syndrome elements and BUN was analyzed by multivariate logistic regression. Results:The comparison of TCM syndromes showed that the proportion of blood stasis syndrome in higher level group was significantly higher than that of the lower level group [74.60% (94/126) vs. 53.17% (67/126), P<0.01)], and the proportion of toxic heat syndrome in the higher level group was significantly lower than that of the lower level group [52.38% (66/126) vs. 65.87% (83/126), P=0.029]. The comparison of TCM deficiency syndromes showed that the proportion of qi deficiency syndrome and yang deficiency syndrome in the higher level group was significantly higher than that of the lower level group [67.46% (85/126) vs. 45.24% (57/126), P<0.01; 11.90% (15/126) vs. 3.97% (5/126), P=0.032, respectively]. Logistic regression analysis showed that the higher blood urea nitrogen level was correlated with the increased incidence of qi deficiency syndrome ( OR=3.425, 95% CI: 1.934-6.068, P<0.01), yang deficiency syndrome ( OR=3.460, 95% CI: 1.160-10.325, P=0.026) and kidney deficiency syndrome ( OR=2.212, 95% CI: 1.173-4.173, P=0.014) in sepsis patients. Conclusion:Sepsis patients with higher blood urea nitrogen level have a higher proportion of blood stasis syndrome, qi deficiency syndrome and yang deficiency syndrome and may be related to the increased incidence of qi deficiency syndrome, yang deficiency syndrome and kidney deficiency syndrome.

Objective To assess nutritional risks in children with allergic proctocolitis induced by cow milk protein,and to observe the effects of the feeding strategies for them with different interventions in feeding,and then to identify the best time and the best way to modify feeding strategies according to different individual.Methods The effectiveness of different feeding interventions was retrospectively analyzed after 2 weeks in 171 cases with allergic proctocolitis induced by cow milk protein in Hunan Children's Hospital during the period of Jan.2012 to Jul.2013.Thirty-two cases received breast feeding (18.7％) and 139 cases received non-breast feeding (81.3％).Intervention methods:32cases with breast feeding received the same feeding method;among 139 babies with non-breast feeding group,36 were plus free amino acid (AAF) (21.1％),and 103 were plus the extensively hydrolyzed formula (eHF).The intervention formula changes were observed in 8,12 and 24 weeks,respectively,and nutritional risks in 0,3,6 months were assessed,respectively.Results There were 171 patients totally,male to female ratio was 1.5 to 1.0,and the average age was (4.1 ± 1.3) months.After 2 weeks,147 cases were notably effective,accounting for 86％,and in the breast feeding group 79.2％ of the patients were notably effective,and there was no significance compared with the AAF group and eHF group (P ＞ 0.05).The intervention formulation changes during the following 6 months were as follows:in 8 weeks,30 cases in the breast feeding group breastfeeding continued,2 cases turned to eHF feeding for the lack of breast milk,21 cases were fed with AAF (12.3％),85 cases with eHF (49.7％),and 35 cases with moderately hydrolyzed formula (20.5％) ;in 12 weeks:23 cases had breast feeding (13.5％),16 cases were fed with free amino acid formula powder (9.4％),56 cases with extensively hydrolyzed formula (32.7％),and 76 cases with moderately hydrolyzed formula (44.4％) ;in 24 weeks:21 cases (12.3％) had breast feeding,7 cases were fed with AAF(4.1％),13 cases with moderately hydrolyzed formula(7.6％),and 130 cases with normal formula(76.0％).The mean levels of the nutritional risks were assessed according to STAMP in 0,3,6 months respectively:breast feeding group [(1.69 ± 0.78) scores,(1.50 ± 0.88) scores,(1.53 ± 0.67) scores,P ＞ 0.05] ; AAF group [(1.72 ± 0.78) scores,(1.53 ± 0.88) scores,(1.53 ± 0.65) scores,P ＞ 0.05] ; eHF group [(1.80 ± 0.69) scores,(1.68 ± 0.68) scores,(1.66 ± 0.65) scores,P ＞ 0.05].Conclusions The nutrition risk levels in children with milk protein allergic proctocolitis are low,and different feeding interventions according to tolerance had no impact on the nutritional status ; Breast feeding could effectively avoid cow milk allergy,and symptoms of the children with allergic proctocolitis would be relieved after 2-week intervention,and more than half of children could gain part of immune tolerance after intervention for 3 months or more,so for the children with allergic proctocolitis induced by cow milk protein,routine formula feeding should be stopped after 3 months,and individualized feeding intervention can be carried out according to immune tolerance to relieve the financial burden.

Objective To investigate whether there is a correlation between carbohydrate antigen125(CA125) and inflammation indicators in gynecological diseases ,analyze the possible mechanism of the disease .Methods Retrospectively analyze the regression and correlation between CA125 and routine blood classification indicators in 4 291 patients from department of reproductive health and gynaecology .Stepwise multiple regression model was used to analyze the common disease from department of gynaecology in‐cluding pelvic infection ,endometriosis ,uterine fibroids .Results The analysis of 4 291 cases showed that there was a correlation be‐tween CA125 and leukocyte count ,neutrophil‐to‐lymphocyte ratio (NLR) .The correlation coefficient was 0 .170 .For diseases of different types ,in patients with pelvic inflammation and endometrial ectopic there were correlations between CA125 and NLR .The correlation coefficient were 0 .290 and 0 .342 respectively .Conclusion There might be a correlation between CA125 and the inflam‐mation indicators .It should be carefully to diagnose cancer related diseases ,especially when inflammatory factors and CA125 in‐creased at the same time .

Objective To know the stability of 3 kinds of traditional Chinese drug injection with different solvent under different temperature and different storage time,and then reference to safty of clinical durgs. Methods Use particle analyzer,UV SpectropHotometer,pH Determination of three traditional Chinese medicine injection,at different temperatures and different times,the nuanber of particles,pH value,the value of UV absorbance Observe changes. Results The records of experimental data by repeated measures analysis of statistics: Ciwujia Injection,Aidi injection combined with normal saline solution after the particles of ≥ 10μm excess pharmacopoeia standards; ≥ 2μm number of particles is considerable,in the 32～35℃,Ciwujia at T=O min Aidi at T=I80 min ,the number of particles are smaller and with statistical significance,its pH value of the standard range. Xuesaitong injection with glucose injection ≥ 10μm particulate mixture at a higher temperature in excess of pH annacopoeia standards,number of ≥ 2 μm particles in the 4～8℃ and 20～23℃,T=30 min and 60 min time less with statistical significance,and its range of pH value less than pHarmacopoeia. Three kinds of Chinese medicine in the Department's largest UV absorbance peak value and appearance almost unchanged. Conclusions Different drugs in their relative Suggestions of temperature,time and place under intravenous drug use,or better terminal filter,in order to improve the safety of clinical medication.

Objective To study anatomy of the tensor fascia latae perforator flap (TFLP flap) and explore its clini-cal application in reconstruction of head and neck defects. Methods Five fresh cadavers were prepared, and mor-phology and blood supply of TFLP flap were examined by microsurgery anatomy. During dissections, the following parameters were recorded: number and type of perforators vessels, diameter of perforators, pedicle length, diameter of the original vessels, course (infra fascia and supra fascia) ,and its position was located by anatomical landmark. Results There were 41 TFLP flap perforators in all specimen with 35 musculocutaneous perforator and 6 septocuta-neous perforator. Original vessel was ascend branch of lateral circumflex femoral artery/vein with average diameter of (3.01±0.49) mm/(3. 28±0.57) mm. The mean pedicle length was (9. 1±0.79) cm. The surface location was (4. 22± 1. 37) cm laterally and (8. 73±2.72) cm beneath to anterosuperior iliac spine. Conclusion With the characteristics of constant position, large caliber and convenient preparation, TFLP flap is useful for operation andoption in reconstruction of head/neck defects and considered as backup of anterolateral thigh flap. The disadvantage of this flap is its short vascular pedicle.

Objective To evaluate the outcomes of children with stage Ⅳ malignant extracranial germ cell tumors. Methods Twenty-five patients were enrolled in the retrospective analysis. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier method with SPSS 13.0. Results Of the 25 children, there were 13 males and 12 females. The mean age at diagnosis was 2 years old (ranged 1 to 11). Five patients receiving chemotherapy in another hospital before (n=1), or giving up treatment after confirmed diagnosis (n=1), or giving up effective treatment after received less than 2 cycles (n=3) were excluded from this analysis. Of the 20 patients, 90.0% (18/20) achieved complete remission and 5.0% (1/20) achieved partial remission after treatment. The 5-year EFS rate and 5-year OS rate were 70.0%±10.2% and 82.4%±9.2% respectively. There was no death occurred due to complications. Conclusions The effect of this treatment program is positive. The cumulative dose of the drugs is not high, compared with other schemes such as PEB, but there are more drugs involved. Whether these drugs may cause long-term adverse reactions needs further research.

Objective To investigate the antimicrobial resistance and genotype distribution of staphylococcal cassette chromosome mec (SCCmec) of staphylococcus aureus (S.aureus) isolated from children hospitalized at Pediatric People's Hospital of Zhongjiang County.Methods Seventy-seven strains of S.aureus were collected by nasopharyngeal swabs at the Pediatric Department of People's Hospital of Zhongjiang County from January to December 2015.Methicillin-resistant staphylococcus aureus (MRSA) and methicillin-susceptible staphylococcus aureus (MSSA) were identified by cefoxitin disc diffusion and detection of mecA method.The minimum inhibitory concentrations (MIC) of antibiotics were determined by E-test method.SCCmec typing on MRSA strains was performed by using multiplex PCR.Results MRSA accounted for 54.5％ (42 strains) strains of 77 strains.All MRSA strains were resistant to Penicillin,and the rates of antibiotic resistance to Cefuroxime,Ceftriaxone,Erythromycin were 78.6％,95.2％ and 97.6％,respectively.The rates of antibiotic resistance of 35 MSSA to Penicillin and Erythromycin were 97.1％ and 62.9％,and they were also sensitive to other antibiotics.In 42 strains of MRSA,SCCmec type Ⅳa was the predominant type (27 strains,64.3 ％),which was followed by type Ⅳ g and Ⅴ (each 5 strains,11.9％),type Ⅳ c and Ⅳh (each 1strain,2.4％).Non-susceptibility rate of SCCmec Ⅳ to cefuroxime was significantly higher than that of other SCCmec types (P ＜ 0.05).Conclusions All strains from children hospitalized in People's Hospital of Zhongjiang County are often resistant to Penicillin and Erythromycin.The proportion of MRSA isolated from hospitalized children was high.SCCmec type Ⅳa is the main genotype of MRSA.

Objectives To analyze the clinical features and long-term follow-up results of neuroblastoma (NB) without chemotherapy and radiotherapy, and to provide evidence for further improvement of treatment. Methods The clinical data of children diagnosed with NB who received operation during January 2005 to December 2015 was retrospectively analyzed, and the long-term follow-up results were evaluated. Results In 57 cases of NB, 43 cases (81.1％) were in stage 1, 8 cases were in stage 2 and 2 cases were in stage 4S. The median age at diagnose was 7 months (11 days - 10 years and 11 months). There were 47/51 cases had the pathological type with a good prognosis (accounting for 92.2％). FISH was detected in 1/49 case which had the amplification at greater than 10 copies. 56/57 cases underwent surgical resection of the primary tumor, 50 cases of which were completely resected, and 3 cases had very good partial remission after tumor resection. The abdominal mass was found in the uterus in 1 case, and surgical operation was not performed and the imaging was regularly checked for follow-up , and the mass subsided completely at 7-month-old. The median follow-up time was 36 months (4 - 99 months). Five children were lost to follow-up and the median time of follow-up was 19 months (4 - 45 months). One child in stage 4S relapsed at 1 year of follow-up, 2 cases in stage 1 relapsed at 6 months of follow-up. Five years event free survival rates (EFS) in all patients were 94.6％, and overall survival rate (OS) of the 5 years was 100％. Conclusions Children younger than 18 months without MYCN amplification in the stages 1 and 2 are safe by surgical treatment alone with good prognosis. Simple surgical treatment can also be extended to all age groups of NB without MYCN amplification in the stages 1 or 2.