Objective To explore the correlation of NT‐proBNP concentration and the fluid infusion volume in the patients with severe burn ,and to evaluate the significance of monitoring NT‐proBNP in severe burn patients .Methods Fifty cases of severe burn in 100 Hospital of PLA form September 2012 to September 2015 were selected ,without major disease history and genetic history before admission ,among them ,25 cases(group A) had the burned area 35% -50% TBSA or Ⅲ degree 10% -20% TBSA ,18 cases (group B) had the total burn area of >50% TBSA or Ⅲ degree >20% TBSA for group B and 10 cases(group C) had the total burn area>90% and were composite explosive injury .The NT‐proBNP concentrations were monitored on 1-30 d after admission for guiding blood transfusion and fluid infusion;contemporaneous age‐matched 53 patients with plastic surgery were selected as the control group .Compared with the calculation formula of the fluid volume ,the guiding advantage of NT‐proBNP was analyzed .Re‐sults The practical fluid volume in these burn patients were higher than that calculated by the common fluid replacement formula . The more severe burn ,the higher the NT‐proBNP concentration and the more blood products were demanded;the NT‐proBNP con‐centration ,fluid infusion volume ,MAP infusion volume and PLT transfusion volume had statistical difference between the group C and B and between the group B and A (P<0 .05) .Conclusion The NT‐proBNP concentration change may have a higher guidance and early warning significance for middle and long term rational control of blood transfusion and fluid infusion volume in the pa‐tients with severe burns .

Objective To establish a liquichip method for detecting 6 sub-genotypes of hepatitis C virus(HCV),including 1a, 1b,2a,3a,3b and 6a.Methods The coupling method of PCR amplification and nucleic acid probe was established.The PCR product and the microspheres mixture of the coupled nucleic acid probe were hybridized for establishing the liquichip detection method.The sensitivity and specificity of the established liquichip detection method were evaluated.Nucleic acid in 93 serum samples was detec-ted by this method..Results The established HCV nuclei acid liquichip genotype detection method had the higher specificity and sensitivity,which could detect and classfy 6 HCV sub-genotypes.The sensitivity for HCV 1a,3a and 6a sub-genotypes was 1× 105 copies/PCR;the sensitivity for HCV 1b,2a and 3b sub-genotypes was 1×104 copies/PCR.The detection results in 93 serum samples showed that the this genotyping method had the characteristics of high throughput,rapidness,sentsitivity and specificity. Conclusion This method can be used for the simultaneous and quick detection of 6 HCV sub-genotypes and provides a new meth-od for the genotyping detection of HCV.

There are relatively few studies on the association between chronic hepatitis B virus (HBV) infection during pregnancy and gestational diabetes mellitus (GDM), with inconsistent conclusions. A meta-analysis of 23 cohort studies conducted in 2018 showed that HBsAg-positive pregnant women had a higher risk of GDM, which was consistent across the populations from different geographical regions and studies. Although studies have confirmed the association between HBV infection and GDM, the underlying mechanism remains unclear. This article analyzes the possible mechanism of GDM caused by HBV infection, investigates the influence of chronic HBV infection on maternal and neonatal outcomes of women with GDM, and discusses the challenge for women with HBV infection after the implementation of the “universal two-child policy”. It is still a goal for medical workers to strengthen the monitoring of pregnant women with chronic HBV infection and neonates and reduce the complications of mothers and neonates.

Objective:To compare the pregnancy outcome before the implementation of management specification of cervical ripening with dinoprostone suppository with that after the implementation and explore its safety for cervical ripening .Methods:The clinical data of 612 puerperants ,who received cervical ripening with dinoprostone suppository and delivered in First Mater‐nal and Infant Hospital Affiliated to Tongji University during Sep 2012 and Feb 2014 ,were retrospectively analyzed .The man‐agement specification of cervical ripening with dinoprostone had been implemented since Apr 2013 .The maternal and neonatal outcomes ,as well as the rate of adverse reactions ,before and after the implementation of management specification of cervical ripening with dinoprostone suppository were compared with each other ,so as to explore its effects on pregnancy outcome .Re‐sults:There were 449 puerperants receiving cervical ripening with suppository before the implementation of management speci‐fication in Apr 2013 and 163 cases after that .Totally 413 cases(67 .5% ) were induced labour successfully .The success rates of inducting labor within 48 h ,24 h and 12 h after the implementation of management specification were lower than that before the implementation of management specification ,but there was no significant difference .The cesarean rate was 27 .1% and there was no statistically significant difference between the cesarean rate before the implementation of management specification and that after the implementation .There was no statistically significant difference in Apgar score and admission rate to ICU between the two groups .The incidence rates of tachysystole and hypertonus ,meconium‐stained amniotic fluid after the implementation of specification were significantly lower than that before the implementation ,and the difference was statistically significant(P<0 .05) .There was no statistically significant difference regarding the incidence rates of uterine hyperstimulation and the clinical chorioamnionitis .There was no occurrence of complications as amniotic fluid embolism and severe perineal laceration .Conclusions:Di‐noprostone suppository is a safe and effective method for cervical ripening and labor induction .The implementation of management speci‐fication is conducive to protecting maternal and infant and reducing the adverse pregnancy outcomes .

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.