Hepatitis C virus (HCV)-related thyroid dysfunction is a common complication in patients with chronic hepatitis C,including Graves' disease,Hashimoto thyroiditis,destructive subacute thyroiditis,hyperparathyroidism or hypothyroidism,with or without abnormal autoantibodies or thyroidrelated antibodies.The possible pathogenesis of HCV-related thyroid dysfunction includes bystander activation,molecular mimicry,effects of interferon and susceptibility associated with genetic polymorphism on particular locus.By now,there is still no criteria for diagnosis and treatment of HCV-related thyroid dysfunction.For patients with mild HCV-related thyroid dysfunction,observation may be appropriate; and for those with serious symptoms,anti-thyroid drug,levothyrocine,surgery or symptomatic treatment may be applied according to clinical symptoms.This paper gives an overview of the prevalence,clinical characteristics and possible pathogenesis of HCV-related thyroid dysfunction.

Objective:To study the promotion effect of recombinant human acidic fibroblast growth factor ( rh-aFGF) on wound healing in children with surgery or accident injury. Methods: Totally 206 cases of injured children were randomly divided into two groups, the treatment group was given rh-aFGF, and the control group was treated with basic fibroblast growth factor (bFGF). The ob-servation of wound healing, infection and fat liquefaction in the children was recorded in 7 days,and the modification of scar, pigmenta-tion and adverse reactions were observed in 6 months after the treatment. Results:After the 7-day treatment by rh-aFGF and bFGF, the healing rate respectively was 88. 4% and 74. 2%, and the residual wound area was (2. 2 ± 1. 1) cm2 and (3. 9 ± 2. 4) cm2,respec-tively. Six months after the treatment, the scar incidence rate of the treatment group and the control group was 27. 2% and 67. 5%, and the incidence of pigmentation was 30. 1% and 69. 9%, respectively. Conclusion:Rh-aFGF is more effective than bFGF in pro-moting wound healing in children with surgery or accident injury. It can effectively promote wound healing, shorten the healing time, and diminish the area of scar and pigmentation.

OBJECTIVE:To clarify the bio-transformation form of apigenin in rats,and to speculate its possible metabolic path-way. METHODS:Rats were divided into blank group and medication group(apigenin 200 mg/kg,i.g.)with 6 rats in each group. Urine and feces samples were collected from 2 groups within 24 h after medication. After corresponding treatment,urine and feces samples were analyzed and detected by HPLC-IT-TOF-MSn under cation mode and anion mode. RESULTS:9 metabolites were iden-tified in urine sample of rats from medication group,i.e. 2,3-double bond reduction of apigenin (U1,U7,U8,U9),bonded to glucuronic acid(U2,U3,U4),bonded to sulphate(U5,U6,U7,U8,U9)and bonded to glucose(U2). 4 metabolites were iden-tified in feces sample of rats from medication group,i.e. 2,3-double bond reduction of apigenin(F3),bonded to glucuronic acid (F2)and bonded to glucose(F1). CONCLUSIONS:Apigenin mainly exists in form of prototype drug in rats. The reduction hap-pens on 2,3-double bond by the intestinal bacteria,and the product of apigenin boned to glucuronic acid or glucose can be formed when excreting in intestinal tract and rats in vivo,while the product of apigenin boned to sulphate can be formed only when excret-ing in rats in vivo.

The paper introduces and summarizes the teaching purpose and content project,implementation and effect of the optional course in Excel and medical data analysis.

Objective To treat femur fracture in neonates using a new homemade harness designed and observe the effec of this harness. Methods Designed a new harness used in femur fracture in neonates,and used this harness in 7(8 femur fracture)csses,including 6 boys(7 femur fracture)and 1 girl,the age from 1 day to 12 days(average 4.7 days).Those cases included proximal thirds(2 cases)and middle thirds(6 cases)of femur fracture.The angle of fracture was from 44°to 83°(average 62.4°)before treatment. Results The angle of fracture was from 0°to 22°(average 14.0°)after treatment using the harness.Hespitalization was from 2 to 3 days.There were no skin sloughing or harness breaking off.All cases were followed up 6 to 36 months(average 21.3 months).All femur fracture healed in good alignment with leg-length discrepancy＜1 cm.Movement of hip and knee was normal. Conclusions The harness is a better method to treat femur fracture of the proximal and middle thirds in neonates.Advantages of it include simply operation,minimal hospitalization,minimal cost,and easy nursing.

OBJECTIVE:To provide reference for rational use of respiratory inhalants. METHODS:The utilization of respiratory inhalants in 34 hospitals from Nanjing area during 2012-2014 was analyzed by SPSS13.0 software in respects of DDDs,consumption sum,DDC,health insurance and self-paying cost and so on. RESULTS:Respiratory inhalants involved 4 kinds of drugs, 5 kinds of dosage forms,12 kinds of general name and 38 kinds of trade name(specification)in 34 hospitals from Nanjing area during 2012-2014. The total DDDs and total consumption sum of respiratory inhalants increased from 10 827.46×103 and 71,006, 500 yuan in 2012 and 14 627.25×103 and 99,137,100 yuan in 2014,there was no statistical significance(P>0.05). 4 categories of respiratory inhalants in the list of DDDs were anticholinergic agents,compound preparations,glucocorticoid and β2 receptor agonists; DDDs of each type increased year by year,but only that of anticholinergic agents had statistical significance(P<0.01). Consumption sum were glucocorticoid,compound preparations,anticholinergic agents and β 2 receptor agonists;consumption sum of each type increased year by year,but there was no statistical significance(P>0.05). 5 kinds of inhalants in the list of DDDs were aerosol preparation,power aerosols,atomizing solution,nasal spray and clickhaler. DDDs of aerosol preparation and power aerosols increased year by year,with statistical significance(P<0.05). Top one in the list of consumption sum was power aerosols during 2012-2013 and atomizing solution in 2014;power aerosols took up the first place in the list of total consumption in 3 years. Among 12 kinds of general name inhalants,top 4 inhalants in the list of DDDs were ipratropium bromide,salmeterol and fluticasone, albuterol and budesonide,and the constituent ratio of their total DDDs in 3 years were 40.16% ,16.71% ,13.51% and 13.39%,respectively;the sum of constituent ratio of total DDDs in 3 years was more than 80%. Top 3 inhalants in the list of consumption sum were budesonide,salmeterol and fluticasone, budesonide and formoterol,and the sum of constituent ratio of their total consumption sum in 3 years were 39.59%,20.81% and 12.50% ,respectively;the sum of constituent ratio was more than 70% . DDC of salbutamol was the lowest. Among 38 kinds of trade name(specification)inhalants,the type and cost of health insurance accounted for 92.11% and 95.02% .Pulmicort atomization suspension and Symbicort Turbuhaler(160 μg)took up the first place in the list of health insurance cost and self-paying cost respectively,and they were B directory of health insurance. CONCLUSIONS:The utilization of respiratory inhalants was basically reasonable in 34 hospitals from Nanjing during 2012-2014.

Objective To evaluate the diagnostic value of multi-slice spiral CT (MSCT)for traumatic spleen and liver rupture.Methods We made a retrospective analysis of 140 cases of liver and spleen injury with clinical manifestations confirmed by operation.MSCT examination results and clinical data were compared.Results Of the 140 cases,male patients outnumbered female ones,and the peak age was 10 - 30 years old.The injuries were most commonly attributed to traffic accident and falling.There were 69 (49%)cases of spleen injury,5 1 (36%) cases of liver injury,and 20 (14%)cases of both.Liver and spleen injuries showed on MSCT examination were liver and spleen laceration, hematoma within the liver and spleen as well as hematoma beneath the envelop. Conclusion MSCT has an important diagnostic value for traumatic liver and spleen rupture and thus can guide clinical treatment choice.

Objective To discuss clinical efficacy of the modified Stoppa approach in the treatment of acetabular anterior fractures.Methods From January 2011 to December 2014,22 patients with acetabular anterior fracture were treated at our department.They were 14 males and 8 females,with an average age of 36.6 years (range,from 18 to 49 years).By the LetourneI-Judet classification system,there were 9 anterior wall fractures,12 anterior column fractures,and one transverse fracture.The modified Stoppa approach was used for fracture reduction under direct visualization in this cohort.Fixation with reconstruction plate was conducted after satisfactory reduction was confirmed by the X-ray examination.The operative duration,incision length,bleeding volume,fracture reduction quality,function of the affected hip and complications were recorded.Results In this cohort,the incision length ranged from 6 to 15 cm,averaging 9.5 cm;the intraoperative bleeding volume ranged from 100 to 1,000 mL,averaging 550 mL;the operative duration ranged from 40 to 160 minutes,averaging 126.2 min.The 22 patients were followed up for an average of 15.5 months (from 12 to 18 months).According to the Matta imaging evaluation,the fracture reduction was rated as excellent in 18 cases,as good in 3 cases and as poor in one,yielding an excellent to good rate of 95.5％.According to the Harris scoring system,the function of the affected hip was assessed at the final follow-up as excellent in 12 cases,as good in 9 cases,and as poor in one case,giving an excellent to good rate of 95.5％.Traumatic arthritis occurred in one case;there were no such complications as reduction loss or implant failure.Conclusion The modified Stoppa approach is a satisfactory one for the treatment of unstable acetabular anterior fractures,owning to its advantages like minimal invasiveness,simple dissection,excellent visual control of reduction and fixation,and a low rate of complications.

Objective:To investigate the clinical and genetic mutation characteristics of a pedigree with familial exudative vitreoretinopathy (FEVR) associated with a LRP5 gene mutation. Methods:A pedigree investigation was performed in a two-generation Chinese Han family with FEVR, which was diagnosed in The First Affiliated Hospital of Xi'an Jiaotong University.Three family members, the proband and his parents, underwent ophthalmic examination, including visual acuity, intraocular pressure, slit-lamp microscopy, fundoscopy and wild-field fundus fluorescein angiography (FFA), to clinically characterize the FEVR phenotype.Peripheral blood of the families were collected for high-throughput sequencing and bioinformatics analysis to identify the pathogenic gene.Sanger sequencing verification was conducted for the detected mutation.The pathogenicity of identified mutations was analyzed according to the guidelines of the American Association of Medical Genetics (ACMG) with software such as Mutation Taster, Polyphen-2, PROVEN and REVEL.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The First Affiliated Hospital of Xi'an Jiaotong University (No.2017-740). Written informed consent was obtained from each subject.Results:The proband was a 27-year-old male.Uncorrected visual acuity (UCVA) was 1.0 for his right eye and 1.2 for his left eye.Fundoscopy showed vascular tortuosity and vasodilation in the temporal peripheral retina of both eyes.FFA indicated that hairbrush-like vasculature and non-perfusion lesion in peripheral retina.The best-corrected visual acuity (BCVA) of the proband's mother, a 51-year old female, was 1.0 for the both eyes.Temporal retinal vascular tortuosity in her left eye was found with fluorescein leakage detected by FFA.The BCVA of the proband's father, a 56-year-old male, was 1.0 for both eyes.Leopard fundus and optic disc atrophy were visible.FFA result was normal.The result of genetic test showed that there were two novel gene mutations in the family with LRP5 gene c. 4110T>G(p.Cys1370Trp) and FSCN2 gene c. 1495G>A(p.Gly499Ser). According to guidelines of ACMG, LPR5 c. 4110T>G was a mutation with uncertain significance.Multiple software, such as MutationTaster, Polyphen-2, PROVEN and REVEL predicted that LRP5 c. 4110T>G mutation might cause detrimental effects on genes or gene products.REVEL scale was 0.93, which indicated that it might be a pathogenic variant. Conclusions:LRP5 gene c. 4110T>G(p.Cys1370Trp) may be a novel mutation for FEVR, which enriches the mutation spectrum of LRP5 gene.

Objective To investigate the nosocomial infection status in adult patients after cardiac surgery , who suffered cardiac shock and were supported with extracorporeal membrane oxygenation(ECMO).Methods The data of this retrospec-tive analysis were collected from adult patients of postoperative cardiac shock supported with veno-arterial( VA) ECMO from January 2011 to December 2013 in the Center for Cardiac Intensive Care, Beijing Anzhen Hospital.Results 125 patients were enrolled and nosocomial infection occured in 44 patients(51 episodes), infection rate was 35.2% or 71.8 episodes per 1 000 ECMO day.Respiratory tract infection occured most(27.2%), and then bloodstream infection(12.8%).The infection increased in the extension of time.The cultivation of the phlegm and blood specimen showed that the major pathogens were gram-negative bacteria.The patients were divided into the infection and the non-infection groups, the incidence of remedially continuous renal replacement therapy were significantly higher in the infection group than that in the non-infection group and the duration of ECMO support, the lenth of postoperative hospital stay, and the lenth of ICU stay were significantly longer in the in-fection group than those in the non-infection group[40.9% vs.22.2%, P<0.05; (7.2 ±4.6) d vs.(4.9 ±2.1) d, P<0.01;(12.5 ±6.2) d vs.(9.1 ±4.9) d, P<0.01和24(13, 36) d vs.15(11,20) d, P<0.01; respectively].The pa-tients in the infection group had higher mortality compared with the patients in the non-infection group(53.5% vs.17.1%, P<0.01).Conclusion Nosocomial infection is one of the common complications of the ECMO treatment and affects the prognosis of patients.The strict aseptic technique and rational application of antibiotics may reduce the mortality .