Objective To investigate the clinical value of human soluble endothelial protein C receptor (sEPCR) after heart valve replacement.Methods 78 cases of patients with heart valve replacement in the Second Affiliated Hospital of Nantong University from January 2005 to June 2016 were selected as the research objects,who were divided into embolic group and control group,38 cases in embolic group and 40 cases in control group,the index of two groups 1 d preoperative,while dynamic monitoring international standardization ratio (INR) and embolism,were detected,of which INR and sEPCR were examined.The INR and sEPCR oftwo groups was compared with t test.Results The INR and sEPCR of two groups 1 d preoperative had no significant difference (1.24±0.32 vs 1.23±0.19,34.91±9.14 μg/L vs 35.56±10.22 μg/L;t=0.17,P =0.868;t=0.30,P=0.768,respectively).The average value of dynamic monitoring INR in control group had no significant difference when compared with the results of embolism (1.86±0.95 vs 1.93±0.97,t=0.32,P=0.748).But the sEPCR had significant difference (101.33±27.15 μg/L vs 41.67±11.82 μg/L,t=12.69,P=0.000).Conclusion The important indexes of sEPCR could effectively guide the anticoagulant treatment,especially those who with the sEPCR value too high,the embolic threatening should be paid attention to.

Based on the analysis of current condition of local medical schools and medi-cal talents demand at the grassroots level,this paper indicates that,taking students’personality development as a breakthrough point,with practice platform construction as main part,supple-mented by multi-knowledge hierarchy and scientific and cultural exposure,backed by workable policy.

Burnout, Professional ; psychology ; Faculty ; Female ; Humans ; Male ; Mental Health

OBJECTIVETo investigate the clinical application of pedicled superficial circumflex iliac artery (SCIA) flaps in Burns and Plastic Surgery.

METHODS19 cases with skin and soft tissue defects were repaired with the Superficial circumflex iliac artery flaps. The defects located in the hand and forearm, the lower abdomen and perineal area, the radicle area of thigh, etc. Before the SCIA flaps were transfered to the recipient areas, 15 cases with different kinds of wounds were debrided thoroughly, 3 cases with scar were removed directly. The size of the flaps ranged from 3.0 cm x 4.5 cm to 26.0 cm x 22.0 cm, and the pedical was 5 cm to 7 cm in length.

RESULTSThe flaps in the 18 cases survived completely. Skin necrosis in the distal end of the flap appeared in 1 case, and the wound healed after the second repair. The follow-up period rang from 3 to 18 months. The apperance and function of the hand or foot was satisfactory.

CONCLUSIONSBecause the pedicled SCIA flaps can be obtain conveniently and contain sufficient blood-supply, so the flap is easy to survive and the flap can be designed in a large size. We believe it is an ideal method to use this flap to repair skin and soft tissue defects located in hands, forearms, the lower abdomen and perineal areas, the radicle area of thigh and so on.

Burns ; surgery ; Forearm ; Graft Survival ; Hand ; Humans ; Iliac Artery ; Necrosis ; Reconstructive Surgical Procedures ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; pathology ; transplantation ; Thigh ; Wound Healing

Objective To analyse the causes of medical complaints ,seek methods to prevent medical disputes .Methods All medical complaints were collected and analyzed retrospectively in 2011 .Results In 278 medical complaints ,there were 161 (57 .91% ) complaints by telephone ,101 (36 .33% ) complaints by hospital electronic touch screen ,16 (5 .76% ) complaints by E-mail;the top three complaint departments were vasculocardiology department 33(11 .87% ) ,department of gynaecology and obstet-rics 29(10 .43% ) ,urology department 26(9 .35% ) ,respectively ;the top three complaint reason were poor doctor-patient communi-cation 101(36 .33% ) ,poor service level 69(24 .82% ) and ward disadvantaged 45(16 .19% ) ,respectively .Conclusion Prevention of medical complaints of the most important measures is to improve the skill of doctor-patient communication and technical level of medical staff .Furthermore ,hospital should strengthen the construction of infrastructure .

Anemia, Aplastic ; diagnosis ; etiology ; Benzene ; poisoning ; Expert Testimony ; Humans ; Male ; Occupational Diseases ; diagnosis

Objective:To explore the association of its polymorphism of TFRC with the susceptibility, clinical and pathologic phenotypes of IgA nephropathy. Methods: A total of 380 patients with IgA nephropathy and 250 normal controls were enrolled in the study. The regions with 424G/A and -5184C/T polymorphism sites of TFRC were amplified by PCR from genomic DNA and then the PCR-RFLP were performed by restriction enzymes, BanⅠ and BsmA Ⅰ, respectively. The genetic association of genotypes with the clinical and pathologic phenotypes was analyzed. Results: The distribution of frequency in TFRC was consistent with Hardy-Weinberg equilibrium; however, we found no significant difference in genotypes distribution between patients and controls. There were no differences between genotypes in age, blood pressure, 24 h urine protein excretion, serum creatinine, creatinine clearance and serum IgA. 424G/A and -5184C/T polymorphisms were associated with immunofluorescent intensity of IgA deposit in mesangial area, though there was no difference in pathological lesions evaluated by HAAS grade. Conclusion: The polymorphisms of TFRC in 424G/A and -5184C/T sites were not associated with susceptibility to IgA nephropathy, but associated with density of immunofluorescence of IgA in mesangium in our large population based Chinese patients. The association of IgA nephropathy and other polymorphism sites, as well as interaction between TFRC polymorphism and other genes' polymorphisms, neededs to be further investigated.

Adult ; Bone Neoplasms ; pathology ; Humans ; Lymphoma ; pathology ; Male ; Spine ; pathology

Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods