Objectives To investigate the causes of short stature in Turner syndrome (TS). Methods 86 patients were di-agnosed with TS by karyotypes from 2004 to 2013. According to the deletion types of the X chromosome short arm, growth hor-mone (GH), insulin-like growth factor-1 (IGF-1) and thyroid function, the TS patients were divided into different groups and com-parison was made among groups. Results Ht SDS in three groups with different extent of the deletion of the X chromosome short arm were (-4.39±1.08), (-3.26±1.25) and (-2.84±0.15) (P<0.05). The proportion of growth hormone deifciency (GHD) in the three groups were 62.5%, 38.9%and 0%(P<0.05). Ht SDS in groups with different degree of IGF-1 level were (-4.37±1.10), (-3.82±1.07) and (-3.25±0.91) (P<0.05). There was no signiifcant difference of Ht SDS between hypothyroidism patients with and without GHD (P>0.05). Conclusions The deletion of X chromosome short arm may cause the short stature in TS. The GH-IGF-1 axis in TS is impaired, but GHD is not related to short stature in TS.

Objective To discuss the cognition of the nursing disputes in undergraduates and the college nursing students in internship in Changchun and to provide some basis for them to improve the nursing quality in clinic.Methods The investigation was carried out to survey the cognition of the nursing disputes in 266 undergraduates and the college nursing students in internship in Changchun,and the results underwent analysis.Results Most undergraduates and college nursing students held the opinion that at present the relationship between patients and nurses was on a tight rope.94 people accounting for 72.3％ in undergraduate students,89 people accounting for 65.4％ in the college nursing students.Relevant factors which caused nursing disputes were related with the different education backgrounds.Conclusions We should make clear the causes of nursing disputes,and put forward the corresponding proposals according to nursing students with different education degrees.

Objective This research is to observe the treatment effects of hip bath and oxygen blowing on severe neonatal diaper rash.Methods 289 neonates with severe diaper rash were randomly divided into three groups.91 cases in the flat tube group,102 cases in the round tube group and 96 cases in the control group.Three groups of neonates were cleaned on the hips and perineuma after poops and then dried with wet tissues and Mupirocin Ointment.The control group was treated with the above-mentioned method.The oxygen blowing groups were treated with hip bath of 1:5000 chameleon solution twice a day.Blowing the hips with oxygen five minutes every time after hip bath.The method of blowing oxygen was that oxygen humidifying containers as normal oxygen aspiration facilities was not filled with water,whose oxygen flowing volume standed at 10 L/min and whose tube blew at the afflicted parts until being dry.The oxygen blower held the oxygen exit and blowed at the afflicted parts in the round tube group and the oxygen blower flattened the oxygen exit and blew at the afflicted parts in the fiat tube group.The treatment effects will be compared among the three groups four days later.Results The cure period of the round tube group was obviously shorter than that of the control group,and the cure period of the fiat tube group was remarkably shorter than that of the round tube group.The total effective rate in the round tube group was obviously higher than that of the control group and the total effective rate in the fiat tube group was obviously higher than that in the round tube group.The difference had a statistical significance.Conclusions The treatment effects for the severe neonatal diaper rash with hip bath and oxygen blowing are remarkable and the oxygen blowing effects with fiat tubes are better than those with round tubes.

10.3969/j.issn.1000-3606.2013.06.004

Objective To analyze the clinical characteristic s of an infant with congenital lipoid adrenal hyperplasia (CLAH),and to sequence the acute regulatory protein (steroid acute regulatory,StAR) gene of the infant patient and her pedigree.Methods Physical examination,laboratory tests,and imaging examination of the 11-month-old patient with CLAH were collected.DNA was extracted from blood samples of the patient and her parents.The 7 exons of StAR gene were amplified by PCR and then sequenced.Results Dark skin,girl vulva,and one each 1.0 cm×1.0 cm palpable lump in inguinal area bilaterally were observed.The adrenocorticotropic hormone (ACTH) was 253 pg/ml,cortisol was 27.6 nmol/L at 8 am,17-hydroxyprogesterone was 3 nmol/L.Uhrasound showed that sign of testicular ultrasonography existed in bilateral inguinal regions.Karyotype analysis showed 46,XY.Sequencing of PCR amplified fragments showed that there were two heterozygous mutations c.229C ＞ T,p (Gln77X) and C.659A＞G,p (His220Arg) of StAR gene in this patient.By rectifying the disturbance of electrolyte,and treating with hydrocortisone and 9α fludrocortisone,etc,the patient has been stable so far.Conclusion The patient presents typical clinical manifestations.Two heterozygous mutations including c.229C ＞T,p (Gln77X) from maternal and C.659A＞G,p (His220Arg) from paternal of StAR gene were detected.Wherein the c.659A＞G,p.(His220Arg) as a novel point mutation of StAR gene,has not been reported so far.

Objective To compare the effect of L-T4 taken in the morning vs bedtime on serum thyroid hormone in patients with hypothyroidism.Methods Seventeen patients with primary hypothyroidism were prospectively included.They took L-T4 in the morning for 2 months followed by L-T4 taken during the bedtime for 2 months.Thyroid hormone levels and cholesterol,triglyceride,albumin,creatinine and heart rate were measured.Wilcoxon test and paired t test were used to compare the data.The correlation between the changes of TSH and FT3,FT4 was analyzed respectively by Pearson correlation analysis.Results TSH,FT3,FT4 were:(12.10±7.19) vs (3.90±3.47) mU/L,(4.14±0.86) vs (5.24±1.11) pmol/L,(12.72± 4.40) vs (18.48±2.87) pmoL/L for L-T4 taken in the morning and during the bedtime respectively (t value:6.371,-3.166,-5.435,all P＜0.01).There was no correlation between the changes of TSH and FT3,FT4(r=O.12,0.22,both P＞0.05),respectively.The averaged changes were (8.20±5.31) mU/L,(1.09± 1.42) pmol/L and (5.76±4.37) pmol/L.Triglyceride,cholesterol,albumin,creatinine levels and heart rate were not significantly different with L-T4 taken in the morning and during bedtime (t=0.240,0.017;z=0;t=-0.610,1.588,all P＞0.05).Conclusions L-T4 taken during the bedtime by patients with hypothyroidism would reduce TSH and increase FT3,FT4 levels.This method can maintain the stability of TSH level with no need to increase the dose.

Because the influence of fibrin on the reaction of plasm inogen activation by various plasminogen activators is different, the kinetic co nstant of the reaction of plasminogen activation catalyzed by InB with and witho ut fibrin were detected. The result is: Kfibrinm＝4.2 μmol*L -1，greater than the normal Km=0.379 μmol*L-1; kfib rincat＝0.107 s-1，greater than the normal kcat=0.0165 s-1. The results suggest that existence of fibrin in the reaction system of plasminogen activation depress the affinity between InB and plasminog en, but accelerates the hydrolysis of plasminogen by InB. The count up effect is inhibition.

Objective To study the strategy of expanding standard donor heart application and to analyze the clinical effect on applying expanding standard donor heart in heart transplantation.Methods 146 patients received heart transplantation in Fuwai Hospital Bering from June 2004 to February 2009.Expanding standard donor heart was defined as prolonged ischemic time over 6 h,advanced age up to 40,and blood type ABO mismathched.Blood type examination and PRA test were done before operation.The donor heart was preserved by sequential perfusion with cold St.Thomas and HTK solution.The patients were divided into groups according to different oversize body weight,ischemic time,and donor age Results There were 11 deaths after operation.Ischernic time of donor heart was 262.1±120.8 min,and that of 21 donors was over 360 min(the longest one was 605 min).There was no significant diffeFence in recipient properties before transplantation.and also there was no significant difference in mortality,heart function,heart rejection,and main morbidity after transplantation and during follow-up.Conclusion These data support continued aggressive utilization of expanding standard donor hearts in heart transplantation.Our experience demonstrates thatproperly expanding standard cardiac allografts application has no effects on the short- and long-term clinical outcome following heart transplantation.

ObjectiveTo explore the morbidity rate of deviation of nasal septum about personnels who take part in physical examination in the enterprise and facilities of Qinhuangdao,and clinic symptom.MethodsTransverse questionnaire investigation and normal physical examination were adopted.2604 personnels who take part in physical examination were choiced.ResultsMorbidity rate of deviation of nasal septum was 17.6％.The rate of men' s exceeds that of women' s.ConclusionMorbidity rate of deviation of nasal septum was rather high,clinic symptom of snuffle was primary.

Objective:To compare the volatile chemical constituents from the shell and kernel of Caesalpinia minax Hance.Methods:The volatile chemical compositions of Caesalpinia minax Hance were obtained by organic solvent-wet distillation and were analyzed by GC-MS equipped with a elastic quartz capillary column HP-5MS 5%Phenyl Methyl Siloxane(30m?0.25mm?0.25?m).The constituents were identified by their mass spectra.The relative percentage of the volatile constituents was calculated from the GC peak areas.Results:One hundred and fifteen kinds of chemical constituents in the shell of Caesalpinia minax Hance were separated and sixty-three of them,which accounts for 54.7%of total volatile constituents, were characterized.There are five kinds whose relative contents were more than 2.0%.One hundred and two kinds of chemical constituents in the kernel of Caesalpinia minax Hance were separated and fifty-one of them,which accounts for 50.0%,were characterized.There are seven kinds whose relative contents were more than 2.0%.Form the shell and kernel of Caesalpinia minax Hance there were forty kinds of chemical constituents the same.The most relative contents were Limonene(5.31%,shell)and 1-Hexanol(12.94%,kernel).Conclusion:This paper reports,for the first time,the comparison of volatile constituents from shell and kernel of Caesalpinia minax Hance.It is helpful for controlling the quality and further researching of Caesalpinia minax Hance.