Objective To observe changes of plasma thrombinogen segment 1+2(FI+2)and D-dimer(D-D)in multiple trauma patients and exphlore their relations with traumatic disseminated intra-vascular coagulation(DIC). Methods A total of 66 multiple trauma patients were divided into minor injury group(ISS＜16 points,21 patients)and severe multiple trauma group(ISS≥16 points,45 pa-tients).Then.severe multiple trauma group were divided into DIC group(12 patients)and non-DIC group(33 patients).Another 10 healthy pemons were served as control group.Venous blood was collect-ed once in the control group and that collected from other groups at days 1,3 and 7 after injury.The F1 +2 concentrarion was detetrained with ELISA.and the D-D concentration was measured by automated la-tex enhanced immunoassay. Results The F1+2 and D-D levels in the minor injury group and sever multiple trauma group were both higher than that of the control group.In the meantime.the F1+2 and D-D levels in severe injury group were remarkably higher than that in the minor injury group.The plasma F1 +2 and D-D levels were elevated continuously in traumatic DIC group and remarkably higher than that in the non.DIC group.in which the plasma F1+2 and D-D levels gradually declined.Plasma F1+2 and D-D levels had significantly positive correlations at days 1,3 and 7 after injury. Conclusions Hiigher levels of F1+2 and D.D at acute stage is not only relevant to the injury severity,but also closely to the occurrence of traumatic DIC after injury.Detection of plasma F1+2 and D-D levels may play an impor-taut role in early prediction of DIC.

Objective To investigate the effect of fibroblast growth factor receptor 3(FGFR3) in development phase of murine small intestine.Methods Wild type mice and their littermate FGFR3+ mice were used to observe their morphology and proliferation characteristics of epithelia of small intestinine in development phase and changes of FGFR3 expression.Results Mutant mice had lower density and their villa were lower than those of the controls.But to the depth of crypt,the results were conversely.Cells in proliferation mainly located in intestine crypt.Mutant mice had more proliferation than the controls at every time point.Expression of FGFR3 was detected at birth(day 1),and the expression was maximal from day7 to day 21,decreasing rapidly thereafter to reach the relatively low at day35.And the expression of FGFR3 also located in intestine crypt,overlapping with that of Brdu.Conclusion FGFR3 improves formation of murine intestine crypt in development phase.

Objective To explore the relation between traumatic disseminated intravascular coagulation (DIC) and the level of plasma thrombomodulin (TM) in severe multiple-injury patients. Methods Sixty-six multiple-injury patients were divided into minor-injury group (ISS

Objective To explore the features, diagnosis and treatment of pulmonary infection after kidney transplantation. Methods The clinical data of 31 pulmonary infection cases among 150 patients underwent kidney transplantation were analyzed retrospectively. Results The 31 patients with pulmonary infection after kidney transplantation included 9 cases of simple bacterial infection, 3 cases of fungus infection, 5 cases of CMV infection, 1 case of TB, 10 cases of mixed infection, and 3 cases of infection with unclear pathogen. 27 cases of the patients(27/31,87.1%) were cured, while 4 cases died of pulmonary infection. Conclusion Pulmonary infection is a common and severe complication after kidney transplantation. Early etiological diagnosis, the prompt treatment of antibacterium,antivirus and antifungus, adjustment of immunosuppression regime, and strengthening the support therapy would improve the curative rate.

[Objective]To investigate the indications,complications and mid-term results of total knee arthroplasties using rotating hinge knee prosthesis. [Methods]Thirty total knee arthroplasties using rotating hinge prosthesis were performed in twenty-eight patients from July 1998 to July 2008.Seven patients were male and twenty-one patients were female.The average age was 62 years(42-75 years).The diagnosis included osteoarthritis in 8 patients,rheumatoid arthritis in 2 patients,traumatic arthritis in 3 patients,Paget's disease patient,serious genu valgum in 7 patients and 10 failure TKAs.All patients were followed up for 12 to 120 months.The patients were evaluated according to knee score system and the complications were observed.[Results]The pain was relieved and function was improved in all knees.The average knee pain score increased from 19.5 to 77.9,and knee function score from 22.5 to 50.5.Range of motion of knees increased from 58.4?to 72.8?.No revision was needed in all patients,The complications included anterior knee pain(8 cases),extension lag(5 cases),prosthesis broken(1 case) and patella tendon rupture(1 case).[Conclusion]The mid-term results of total knee arthroplasty using rotating hinge knee for severe knee deformity are satisfactory.Complications should be prevented carefully.

Objective To investigate the effect of IVIG on pre-existing anti-HLA-A2 Ab levels and graft skin survival.Methods C57BL/6 wild type mice were sensitized to HLA-A2 by intraperitoneal injec-tion (IP) of HLA-A2 TgN mouse spleen cells (C57BL/6-TgN [HLA-2.1]1Enge SC) expressing human HLA-A2 at day 0, week 3 and 4.Sensitized mice were respectively treated with human IVIG , albumin, gly-cine, or PBS for 5 days during week 7.Skin transplantation from TgN mice to C57BL/6 wild type mice was performed at week 10 .Efficacy of IVIG DES was assessed by measuring anti-HLA Ab levels by ELISA pre-/post-Rx and graft skin survival was monitored daily post-Tx.Results Changes of HLA-A2-IgG levels:IgG HLA-A2 class I Ab levels in all groups predictably increased from baseline following spleen cell IP and peaked at week 4 ( P <0.01 ) , indicating sensitization .IVIG-treated mice showed significantly lower IgG Ab levels vs.albumin, glycine and PBS-treated at week 9 post-desensitization ( P <0.01).IgG quickly increased to extremely high levels in all groups following skin transplantation ( P <0.01 ) .Graft skin sur-vival between Rx-groups were similar with all rejecting at about 7 days post-transplantation ( P >0.05 ) . Conclusion However, IVIG alone does not inhibit anti-HLA class I Ab production after skin transplanta-tion or prolong SG survival , indicating combination of IVIG with other immunosuppressant or more optimal protocol for desensitization might show more efficacy and should be under explored .

Objective To investigate the recheck rule by investigating the coincidence rate of the results detected by the LabU‐Mat urine dry chemistry analyzer and the Urised tangible composition analyzer with the results detected by the microscope examina‐tion .Methods 1 040 urine specimens from children outpatients and children inpatients were collected .Firstly ,the specimens were analyzed by the LabUMat urine dry chemistry analyzer and the Urised tangible composition analyzer ,and then detected by using the microscopic examination for investigating the recheck rule of the routine analysis by the urine automatic analyzer ;the regulation was evaluated by the missed detection rate ,and then the recheck rule avoiding the missed diagnosis of abnormal renal function was also evaluated .Finally ,clinically verify the rules adopting 200 specimens to perform the clinical verification on this recheck rule .Results Among the specimens used for researching the recheck rule ,the specimens of positive microscope examination results accounted for 58 .65% ,the specimens of negative results accounted for 41 .35% .In the positive detection specimens ,the specimens of RBC positive were the majority ,accounting for 50% ,the specimens of WBC positive accounted for 23 .08% and the specimens of CAST positive accounted for 7 .69% .The coincidence rate of the set rule was 87 .5% and the missed detection rate was 2 .9% .In conduc‐ting the verification on the recheck rule by 200 urine specimens ,the coincidence rate was 89 .52% and the missed detection rate was 2 .4% .Conclusion When the detection results of occult blood(BLD) ,WBC(LEU) and protein(PRO) by the dry chemistry analyzer and the detection results of RBC ,WBC ,CAST by the tangible composition analyzer are inconsistent or the differences among them are beyond 2 grades of differential ,the recheck by the microscopic examination should be performed .

Objective:To explore the learning experience of the medical massive open online course (MOOC) teaching design standard system constructed by the research group in the early stage.Methods:In this study, the questionnaire was adapted from four dimensions: academic analysis, curriculum content design, teaching process design, and teaching evaluation design, including 519 students majoring in clinical medicine of a university who had studied MOOC cases like "Ultra-early Diagnosis and Treatment of Acute Cerebral Infarction" based on the system. SPSS 25.0 was used for statistical analysis.Results:The system had a high degree of recognition in all dimensions, with 64.5% of academic analysis, 57.6% of content design, 54.5% of teaching design process, and 59.3% of teaching evaluation design.Conclusion:The study has found that the medical MOOC teaching design system has good learning experience effect. According to the data feedback, the key teaching design points such as the core factors of learning experience analysis and the suitability of teaching content in the practical operation of teaching design has been explored, providing the practical basis and method reference for the design of medical MOOC teaching design.

Objective To explore the infection rate of hepadnaviruses and non-hepatotropic virus in infants with biliary atresia(BA)and their relationship between the onset and development of BA.Methods The data and pathogen test records from 184 BA infants who were hospitalized at Guangzhou Women and Children's Medical Center from January 1,2010 to December 31,2014 were reviewed,and the infection rates caused by 3 hepadnaviruses including hepatitis A virus(HAV),hepatitis B virus(HBV),hepatitis E virus(HEV)as well as 5 non-hepatotropic viruses including cytomegalovirus(CMV),Epstein-Barr virus(EBV),herpes simplex virus(HSV),enterovirus(EV),Coxsackie-virus were analyzed.The outpatients or inpatients without BA and immunodeficiency were selected as controls.Results In BA patients,the infection rates of CMV were highest(40.21％,39/97 cases)caused by 3 hepadnaviruses(HAV,HBV,HEV)and 5 non-hepatotropic viruses(CMV,EBV,HSV,EV,Cox),while the infection rates of HAV,HEV,HBV,EBV,HSV,EV or Coxsackievirus were all low,and mixed virus infection was found in 9 patients.The positive rate of CMV IgM in BA group[34.94％(29/83 cases)] was significantly higher than that in the control group[15.69％(8/51 cases)],and the difference was statistically significant(x2=5.86,P<0.05);and the positive rate of CMV DNA in BA group[28.57％(20/70 cases)] was significantly higher than that in the control group[3.70％(1/27 cases)],and the difference was statistically significant(x2=7.10,P<0.05).In BA infants under 60 days,the detection rate of CMV DNA was 45.45％(15/33 cases),which was higher than that in the ones over 60 days[25.48％(5/37 cases)],and the difference was statistically significant(x2=8.72,P<0.01);while the positive rate of CMV IgM had no significant difference among≤60 d group,60-90 d group and ≥90 d group[47.22％(17/36 cases),20.00％(6/30 cases),35.29％(6/17 cases)](x2=5.62,P>0.05).No statistical difference in age was found in BA patients on detection between the positive and the negative group,and the consistency of CMV DNA and CMV IgM was not ideal(Kappa value<0.4).Conclusions Infection of CMV is quite common in BA patients,BA infants under 60 days old show higher detection rate of CMV DNA than the older ones,but there is no difference in detection rate of CMV IgM among different ages,CMV is not supported as a secondary infection and may play a role in the occurrence and development of BA.

Objective To investigate the morbidity of cholecystic disease in renal transplant candidates and study the indications of prophylactic laparoscopic cholecystectomy(LC) for renal transplant candidates with cholecystic disease. Methods The incidence of cholecystic disease in 286 renal transplant candidates in our institution in recent four years was retrospectively reviewed.All the candidates had received one or more ultrasonographic examinations. Results Cholecystic disease was found in 32 of 286 candidates ((11.1)%), including cholelithiasis in twenty(62.4%, 20/32), sludge in six(18.8%, 6/32)and polypoid lesion in six(18.8%, 6/32). Cholecystectomy had been performed in twenty candidates with symptomatic chronic cholecystitis before transplantation, including LC in fourteen and open cholecystectomy with small incision in six .Five of twelve candidates without symptoms received prophylactic LC electively .In three of the other 7 candidates acute cholecystitis occured within six month after transplantation.There was no death of the (candidates) and no grafts function loss occurred in this series. Conclusions Cholelithiasis is the major cause of cholecystic disease in renal transplant candidates. Electively prophylactic LC is recommended for the (candidates) with or without symptomatic cholecystitis before transplantation or before acute cholecystitis has (occured).