Objective:To evaluate the value of B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E mutation detection in the differentiating malignant from benign with Bethesda system for reporting thyroid cytopathology (BSRTC) categories Ⅰ and Ⅲ nodules. Methods:From January 2019 to December 2020, a total of 264 nodules from 263 patients (79 males, 184 females; median age 46 years) were retrospectively enrolled and all patients underwent BRAF V600E mutation detection, fine-needle aspiration cytology (FNAC) and thyroid nodulectomy in the Affiliated Drum Tower Hospital of Nanjing University Medical School. Thirteen nodules of 12 patients had repeat aspirate samples and 51 nodules were examined with multiple genes assay in formalin fixed paraffin embedded tissues. Taken the postoperative histopathological results as the gold standard, the diagnostic efficiency of BRAF V600E mutation was analyzed by comparing the results of multiple genes assay and BRAF V600E mutation detection of repeated puncture samples. Results:Of 264 nodules, 230 were malignant (papillary thyroid cancer (PTC)) and 34 were benign, with BSRTC categories Ⅰ (nondiagnostic) and Ⅲ (follicular lesion) nodules of 58 and 206. The sensitivities of BRAF V600E mutation detection in BSRTC categories Ⅰ and Ⅲ nodules were 77.1%(37/48) and 78.0%(142/182), the specificities were 9/10 and 91.7%(22/24), the positive predictive values were 97.4%(37/38) and 98.6%(142/144), the negative predictive values were 45.0%(9/20) and 35.5%(22/62), and the accuracy rates were 79.3%(46/58) and 79.6%(164/206). The diagnostic concordance of BRAF V600E mutation detection was 90.2%(46/51) in the preoperative and postoperative samples of 51 nodules with preoperative BRAF V600E wild type but postoperative pathology confirmed as PTC and was 11/13 in repeat puncture samples. Conclusion:BRAF V600E mutation detection is an effective diagnostic method for BSRTC categories Ⅰ and Ⅲ nodules.

Objective To explore the clinical experience and surgical method of the repairment of frontal plantar tissue defects by using "tennis racket"-like flap with the medial plantar retrograde,and to study the reliability in the clinical application of the medial plantar retrograde flap.Methods From June 2011 to June 2016,"tennis racket"-like flap with the medial plantar retrograde was used to repair the frontal plantar tissue defects in 10 cases.The cutting range of flap was from 3.5 cm × 2.0 cm to 8.0 cm x 4.0 cm in size;in all patients the donor area was covered by skin grafts.Results All flaps survived and wounds healed by first intention.In 10 patients the donor sites healed primarily with a straight scar,and the appearance and texture of the flaps were satisfactory.All patients were followed up from 6 to 24 months (mean 12 months).According to the Chinese foot function evaluation standard trial evaluation,the outcomes were excellent in 9 cases,good in 7 cases,and medium in 2 cases.Conclusions "Tennis racket"-like flap with the medial plantar retrograde is less anatomic variation with reliable blood supply,and sensory recovery is quick;the donor site is a small crater and cicatrial contractures are light;the cost is low.All patients are treated on one session and therefore it is an ideal method for the repairment of frontal plantar tissue defects.

Objective To study the expression characteristics of Let-7 genes in breast cancer.Methods Twenty-eight patients with breast cancer were randomly selected,and their cancer tissue and adjacent normal tissue were collected.TRIzol was used to extract the total RNA and real-time quantitative PCR was used to detect the relative gene expression levels.Results The expression of precursor Let-7 in cancer tissue was (9.65 ± 2.31),which was lower than that in normal tissue (10.05 ± 2.81),P =0.048.Precursor Let-7 had dependence relationship with the long menstruation (b =0.816,P =0.029).The menarche age showed a positive correlation with precursor Let-7 in normal tissue (r =0.502,P =0.048) and a negative correlation in cancer tissue (r =-0.484,P =0.049) Conclusions The expression of precursor Let-7 in cancer tissue is lower than that in normal tissue.The period of menstruation is a protective factor to breast cancer.

Objective To investigate the expression of phosphorylated mammalian target of rapamycin (p-mTOR) and phosphorylated eukaryotic translation initiation factor 4E binding protein 1 (p-4EBP1) in pathologic scar,and comprehend its role and significance in the pathologic scar formation.Methods SP immunohistochemical method was used to detect the expression of p-mTOR and p-4EBP1 in 20 cases of keloid,20 cases of hypertrophic scar,20 cases of non-pathologic scar and 20 cases of normal skin tissue.The positive rates of expression in different tissues were analyzed,and the relationship in pathological scar was explored.Results The positive rates of p-mTOR and p-4EBP1 in keloidand hypertrophic scar were 75.0％ (15/20),60.0％ (12/20) and 60.0％ (12/20),50.0％ (10/20),nom-pathologic scars were 20％ (4/20),10％ (2/20);normal skin tissue were 10％ (2/20),5％ (1/20),which were higher respectively compared with the two control groups (P＜ 0.05);there was a highly positive correlation between p-mTOR and p-4EBP1 expression in pathologic scar (r=0.323,P＜0.05).Conclusions p-mTOR and p-4EBP1 might be involved and cooperated in promoting the progress of pathologic scars.

OBJECTIVE:To study the preparation technology of Fanhuncao sustained-release dropping pills. METHODS:The preparation technology of Fanhuncao sustained-release dropping pills was optimized by orthogonal design and single factor test with PEG4000,PEG6000 and glycerol monostearate(GM)as carrier materials,using sphericity,pill weight difference and appearance quality as index,GM-PEG weight ratio,liquid temperature,nozzle temperature,dipping speed,dropping distance,diameter of emitter as factors and the verification test was conducted. RESULTS:The optimal technology was that the ratio of GM-PEG was 3∶7;the temperature of drug mixture was 85 ℃;the dropping speed was 40 drop/min;dropping distance was 4 cm;and the conden-sate temperature was 15 ℃;diameter of emitter was 4 mm. RSD of each index of 3 batches of dripping pills were all ≤0.58%(n=3)in verification test;the average content of chlorogenic acid was 0.14 mg/g;the average pill weight difference was 3.21%;the average sphericity was 9.43;and the average appearance quality was 4.33. Q1 h were 23.4%,24.4% and 23.3% in average(n=6),and Q12 h were 89.6%,91.2% and 91.5%(n=6). CONCLUSIONS:The optimal preparation technology is stable and simple, and can be used for industrial production of Fanhuncao sustained-release dropping pills.

Objective To investigate the relationship between C734A and G-2964A polymorphism of cytochrome P450 1A2 gene and clinical efficacy of duloxetine.Methods 223 patients with depression were treated with duloxetine for six weeks.The clinical efficacy was evaluated with the Hamilton rating scale for depression (HAMD) ;single nucleotide polymorphism (SNP) at position C734A and G-2964A of CYP1A2 gene were identified with restriction fragment length polymorphism(RFLPs) ;then one-way ANOVA was adopted to analyze the relationship between SNP and clinical efficacy.Results (1) In 223 patients,the frequency of allele A at locus 734 was 63.64％,while that of allele A at locus-2964 was 26.82％.(2) 220 patient underwent the whole treating course.The conjoint analysis of two locuses indicated that the decreasing ratio of HAMD score of high-activity group,middle-activity group and low-activity after treatment was (56.05± 10.13) ％,(66.36± 8.66) ％ and (73.82± 7.10) ％ respectively,the differences obtained by pairwise comparison of the three groups were of statistical significance(P＜0.01).Conclusion There is close relationship between C734A and G-2964A polymorphism of CYP1A2 gene and clinical efficacy of duloxetine in the treatment for depression.

Objective To study the changes of the symptoms and quality of life in the patients after the transvaginal tape-obtura-tor(TVT-O) operation .Methods To retrospectively analyze the clinical data of 96 female patients with stress urinary incontinence (SUI) in our hospital from February 2007 to April 2012 .48 cases of retropubic tension free vaginal tape(TVT) were taken as the control group and 48 cases of TVT-O as the experimental group .The intraoperative general condition and postoperative symptoms changes and life quality were analyzed and compared between the two groups .Results The operation time ,blood loss and hospital stay time in the experimental group were significantly less than those in the control group (t=17 .061 ,17 .026 ,15 .465 ,P>0 .05) , the difference of operative effects between the two groups was not statistically significant (χ2 =0 .711 ,P>0 .05) .After treatment , all the patients′scores of quality of life were significantly improved compared with that before treatment (29 .1 ± 9 .6 ,30 .3 ± 9 .8 vs . 70 .4 ± 10 .2 ,68 .5 ± 11 .4 ,P<0 .05) ,but score differences between the two groups showed no statistical significance (P>0 .05) ,af-ter treatment ,the symptom scores and urinal pad use of two groups were obviously improved compared with those before treatment (13 .9 ± 2 .8 ,14 .1 ± 2 .5 vs .5 .1 ± 1 .2 ,5 .4 ± 1 .7 89 .6% ,93 .8% vs .50 .0% ,58 .3% ,P<0 .05) ,but the differences between the two groups were not statistically significant (P>0 .05) .Conclusion TVT-O can improve the symptoms and quality of life in the pa-tients with SUI .In the same time ,it has advantages of minimal invasion and low risk ,which is worth promoting ,but the surgeons need to accumulate more clinical experience .

Objective To explore the relationship between vicarious traumatization and personality in trauma helpers. Methods Questionnaire about vicarious traumatization and Revised eysenck personality questionnaire short for Chinese(EPQ-RSC) have been carried out on a random sample of 86 trauma helpers in Wenchuan earthquate region from Tangshan. And all the data of the questionnaire scales will be dealt with by the software SPSS11.5. Results ( 1 ) There were significant gender differences on vicarious traumatization of trauma helpers in emotional reaction( famale :20.03 ± 4.92; male: 15.09 ± 3.93 ), behavioral reaction ( famale: 16. 43 ± 4. 49;male: 12.11 ± 2.57 ), cognitional reaction( female: 10.27 ± 3.28; male: 8.29 ± 2.81 ), faith of life ( famale: 14.17± 3.53; male: 11.20 ± 3.37 ), physiological reaction ( female: 21.23 ± 5.31; male: 17.32 ± 4.80) and the total core of vicarious traumatization( famale: 82.70 ± 17.74; male: 64.00 ± 12.49) (P＜0.01). (2) There were significant differences of vicarious traumatization of trauma helpers on professional training and experience of trauma help (P ＜ 0.05 ). ( 3 ) Comparing to helpers of non-vicarious traumatization, the helpers of vicarious traumatization were high in N scale questionnaire (P＜ 0.01 ). Conclusion Vicarious traumatization of trauma helpers are affected by sex, professional training and experience of trauma help. The best choice of trauma helper is steady emotion personality..

Objective To observe safety and efficacy of intrauterine device MYCu IUD that releases indomethacin. Methods In total, 2000 women requiring IUD for contraception were chosen from domestic multiple clinical centers according to an unified standard. MYCu IUD and TCu380A IUD were randomly inserted for 1000 women each, respectively. All women were regularly followed-up one, three, six and 12 months after insertion. Results All the women were followed-up for 11 985.9 and 11 753.6 person-months in MYCu IUD and TCu380A IUD groups, respectively, with cumulative IUD application rates of 97. 80% and 94. 70%, and cumulative pregnancy rates with IUD of 0. 10% and 0. 31%, respectively. Cumulative expulsion (or partial expulsion) rate in MYCu IUD group was 0. 10%, significantly lower than that in TCu380A IUD one (1.73%), P ＜0. 01, and cumulative removal rate due to medical reasons (bleeding or pain) was 1.51 % and 2. 94%, respectively, P ＜ 0. 05. Rate of IUD-associated termination and overall rate of termination differed significantly between the two groups, P ＜0. 01. Adverse reactions one, three, six and twelve months after IUD insertion included irregular bleeding, prolonged menstruation, increased menstrual blood volume and pain, less in indomethacin-containing MYCu IUD group than those in TCu380A IUD without containing it, P ＜ 0. 01. Conclusions MYCu IUD is a comparatively ideal IUD that should be promoted for extensive use, with extremely low expulsion rate, good contraceptive effect, convenience and safety in insertion and removal, and less adverse effects.