The postoperative management of papillary thyroid microcarcinoma (PTMC) is one of the most important parts of management for PTMC,and it includes the initial management and long-term management of PTMC.The initial management of thyroid cancer is based on initial recurrence risk stratification system.The initial risk stratification system can be used to guide initial TSH suppression therapy,RAI assistant therapy and management of follow up.Initial risk assessment of recurrence,as a static representation of the patient in the first few weeks post-operatively,could not be continually updated during follow up.In order to account for the changes of the recurrence risk and disease specific mortality,re-stratification of risk should be performed during follow up,using all the clinical,biochemical,imaging (structural and functional),and cytopathologic findings obtained during follow up.Re-stratification of risk can inform clinicians on degree of ongoing TSH suppression,frequency and intensity of follow-up,and need for additional therapies were recommended in guideline.Adjustment of TSH suppression therapy should incorporate the impact of side effects and set TSH targets to ensure the benefits of TSH suppression outweigh against the potential risks.

Objective To study the related factors of hemorrhage of uterine scar again after cesarean section,available for peer exchange.Methods A retrospective analysis of clinical data of 650 patients with scar uterus again cesarean section patients,analysis of postoperative hemorrhage patients,the causes of bleeding.They were divided into placental group (n =6),incision dehiscence group (n =7),uterine atony group (n =17)according to the causes of hemorrhage,and related factors of postoperative bleeding were analyzed.Results The bleeding volume of the placental group in operation[(2 500 ±500)mL]was higher than the uterine atony group[(1 300 ±400)mL] and the incision dehiscence group[(700 ±200)mL].The bleeding volume of the uterine atony group was higher than the incision dehiscence group (t =10.29,5.56,4.33,all P <0.05).The bleeding volume of the uterine atony group after operation[(100.09 ±36.45)mL]was higher than the placental group[(90.71 ±20.31)mL]and the uterine atony group[(81.23 ±30.34)mL].The bleeding volume of the placental group after operation were higher than the uterine atony group (t =3.94,3.02,2.78,all P <0.05).4 cases of hysterectomy,3 cases of conservative surgery in placental group.1 case of hysterectomy,16 cases of conservative surgery in uterine atony group.7 cases conservative surgery in incision dehiscence group.Conclusion placental factors,uterine atony,incision dehiscence all can lead to scar uterus again cesarean section hemorrhage.We should also strengthen the clinical prevention work,and actively take relevant measures,reduce postoperative bleeding risk,to ensure the safety of the mother and infant.

OBJECTIVE:To facilitate Chinese pharmaceutical industry's understanding and application of the new "Patent Law".METHODS:The amendment of the "Patent Law" related to 3 aspects of medicine,i.e.specifying regulations on the information disclosure in the utilization of genetic resources,adding the clause of forced permission for the patent drugs for the purpose of public health,and introducing the Bolar exception clause was analyzed using law hermeneutic.RESULTS & CONCLUSIONS:The medicine-related amendment of the new "Patent Law" generally reflects an international tendency of restricting pharmaceutical patents so as to maintain public interests,which is in line with the status quo of low technological level of pharmaceutical industry in China.

Objective To investigate into the indications and related anatomic foundation of transjugular intrahepatic portosystemic shunt(TIPS) creation by direct transcaval approach in patients with portal hypertension cirrhosis suffering unusual anatomy between the hepatic veins and portal bifurcation; and to evaluate the security, feasibility and clinical significance. Methods Direct transcaval approach TIPS were performed in 65 patients including active variceal bleeding (n=52), intractable ascites (n=12), and as a bridge to liver transplantation (n=1). Results Technical and functional success were achieved in all patients. The success rate was 100% without related complications including the technique and primary patency rate is obvious higher than classical TIPS. Conclusion In patients with unusual anatomy between the hepatic veins and portal bifurcation, and inaccessible or inadequate hepatic veins, transcaval TIPS creation is secure and feasible. The results suggest that the direct transcaval approach offering favorable primary patency because the shunt has a straight line in construction.

AIM:To establish the quality control for Finger-citron Formula Granule. METHODS: The TLC,HPLC and fingerprint chromatogram were used to make quality standard. RESULTS: The TLC spots were clear and 5,7-dimethoxy-coumarin showed a good linearity at a range of 0.46-4.14 ?g.The average recovery was(99.01%)(n=6) with RSD 1.58%. CONCLUSION: The method could be used as the quality control of Finger-citron Formula Granule.

Objective To explore the applied value of static and dynamic of virtual defecography technology in the etiological diagnosis of constipation.Methods 50 patients with constipation were included.Conventional cleaning enema was performed firstly.Then they were injected the virtual defecography agentwith lateral position,filling the rectum,sigmoid and descending colon.Thirdly,siting on the qualities commode,adjusting height coincides with the left and right femur,displaying the pubic symphysis and coccyx dynamic acquisition image acquisition with the speed of 4/s,the dynamic changes of the rectum and anal canal were analyzed and measured.Results Among 50 patients,32 cases with rectocele,1 case with rectal bend,2 cases with anal canal stenosis,7 cases with rectal prolapse,4 cases pelvic floor spasm syndrome,and 4 cases with no cause.Conclusion Static and dynamic virtualdefecography was an important method in the etiological diagnosis of patients with constipation.

Objective To evaluate the effect of meglumine cyclic adenosine (MAC) on heart rate variability (HRV) in aged-patients with coronary heart disease (CHD).MethodsSeventy six aged-patients with CHD were randomly divided into control group (n =36) and treatment group (n =40).The patients in control group were treated with nitrate,ozagrel,calcium antagonist,aspirin enteric-coated tablets,low molecular heparin,angiotensin-converting enzyme inhibitor ( ACEI ) or angiotensin receptor antagonist ( ARB ) and lipidlowering agents according to patients' conditions.Based on this,the patients in treatment group were treated with MAC 90 mg intravenous injection once a day for two weeks.The 24 h dynamic electrocardiogram was recorded.pre-ard post-treatment,and the changes of HRV indexes were observed.Results There was no statistical significance in HRV between the two groups before treatment ( P ＞ 0.05 ).However the HRV in two groups improved significantly after treatment ( P ＜0.01 ).The improvement of HRV was more significant in MAC group than that in control group (P ＜0.01 ).Conclusion MAC can significantly improve HRV in aged-patients with CHD.

OBJECTIVE:To improve the safety management level of high-risk drug Insulin injection in our hospital. METH-ODS:The standard management of Insulin injection(400 u/injection)was conducted by using PDCA(plan-do-check-action). The application of Insulin injection in wards was compared before and after six months of management. RESULTS:By strengthening training,improving ward baseline insulin management register system,adjusting the specification of insulin in information system, etc.,the application and storage of insulin became more standard;no expired drugs occurred;the rate of waste drug decreased from 95.06% before management to 22.00% after management,decreasing by 73.06%. CONCLUSIONS:PDCA cycle can im-prove the safety management of Insulin injection in wards effectively.

Objective To promote the development of precision medicine and gene sequencing technologies in China by analyzing the innovation situation in gene sequencing technologies.Methods An innovation situation research analysis frame was established with scientific literature and patent information as its basic data.The innovation situation in gene sequencing technologies was analyzed in aspects of scientific research and technical R & D.Results The research on gene sequencing technologies and technical R & D were focused on tumor diagnosis and treatment,plant gene sequencing,identification of HIV and gastrointestinal flora.Single cell genome amplification technology has greatly promoted the development of gene sequencing technologies.Conclusion The level of gene sequencing technologies and technical R & D in China is approaching to that in the world.

Objective To determine whether the maternal serum interleukin-6(IL-6)and in- terleukin-8(IL-8)concentrations can be used in the antenatal diagnosis of intrauterine infection in premature rupture of membranes(PROM).Methods The level of maternal serum IL-6 and IL-8 were determined by a sensitive enzyme-linked immunosorbent assays in 50 normal late pregnant women,25 patients with PROM but without evidence of IAI and 49 patients with PROM and IAI. Results The maternal serum IL-6 and IL-8 concentrations in patients with PROM and IAI were 301.19?142.34/L and 312.32?149.56 ng/L,which were higher than that in patients with PROM but without IAI(133.22?55.26 ng/L and 125.35?61.30 ng/L)and the normal late pregnant wom- en were(126.59?57.12 ng/L and 112.69?56.02 ng/L),P