AIM: To establish the quality standard of Huoxuejiangu Capsules (Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra, Radix Astragali seu Hedysari, Rhizoma Corydalis, Fructus Psoraleae, etc.). METHODS: Radix Astragali, Rhizoma Corydalis, Radix Paeoniae Rubra, Fructus Psoraleae were identified by TLC. The content of tanshinone Ⅱ A was determined by HPLC. RESULTS: Radix Astragali, Rhizoma Corydalis, Radix Paeoniae Rubra, Fructus Psoraleae could be dtected by TLC. Tanshinone Ⅱ A showed a good linear relationship at the range of 0.106～2.12?g, r =0.9996. The average recovery was 98.6%, and RSD was 1.48%. CONCLUSION: The method established is simple, feasible and reproducible. This study provided a method for quality control of Huoxuejiangu Capsules.

[Objective]To explore the treatment of intertrochanteric fracture with expandable proximal femoral nail and prevention and cure of some related complications.[Method]Fifty-eight cases of closed intertrochanteric fracture,including 28 male cases and 30 female,average 73.2 years old(range from 42 to 88)accepted treatment.The type of fracture according to Evans classification:5 cases were type Ⅰ,7 were type Ⅱ,28 were type Ⅲ,13 were type Ⅳ,and 5 were type Ⅴ.All cases were treated with expandable proximal femoral intramedullary nail after close reduction.[Result]Thirty-eight cases were followed up,from 12 to 36 months,average 18.5 months,all of the cases got clinical healing after 8-10 weeks postoperatively.Hip Harris score average was 91.8.Some complications occurred in 6 cases:1 case had secondary fracture nearby the greater trochanter needling insertion point,1 case femoral head peg was outside of the lock hole,and 1 case femoral head peg tip was broken during operation.And after operation,1 case had coxa vara deformation,1 case had femoral middle and superior segment fracture,and 1 case femoral head peg was exited.[Conclusion]Expandable proximal femoral intramedullary nail has some advantages as:minimal invasive,manipulation convenient,fixation reliability,remove easily,but surgeons must be familiar with the construction and fixation principle of the nail in the primary stage,and perform the operating instruction strictly,to reduce or avoid the complications occurrence because of mis-manipulation.

[Objective]To explore the clinical indication and effectiveness of anterolateral mini-incision for the total hip replacement (THR).[Method]A retrospective analysis of the 34 cases of anterolateral mini-incision was conducted from May 2002 to March 2005,among the patients 23 suffered from displaced femoral neck fractures and 11 suffered from femoral head aseptic necrosis.[Result]All the patients were followed up for 12～36 months with an average of 18 months.The obvious advantages of anterolateral mini-incision for the total hip replacement were as following:less blood loss in operation,less post-operative pain and complications,and early rehabilitation training,without cinch and subsidence in X-ray.Harris score was 92.1 point.[Conclusion]Anterolateral mini-incision for the total hip replacement can be used as an effective method to treat the patients who were extenuation,without abnormalities of hip joint,deossification and osteoporis.Appropriate incision combined with precise procedure can reduce the operative trauma and speed up functional recovery.

Objective To study the anatomical feature s of the retroperitoneal cavity around kidney under laparoscope and to provide ana tomical guidance for laparoscopic surgery. Methods Lapar oscopic renal and ureteral operations were performed on 241 patients (145 men an d 96 women; age range,16-75 years;mean age,45.3 years).Through the videos and ph otographs of these operations,the anatomical features were analyzed.The atlas wa s drawn and surgical access was designed. Results Under laparoscope lateral conal fascia continues from the fascia of quadratus lumborum at its lateral border.This fascia covers posterior lamella of Gerota’s fascia and fuses into transversalis fascia beneath peritoneum. Fusion fascia lies befor e anterior lamella of Gerota’s fascia. It extends laterally and disappears grad ually to the lateral reflexion of peritoneum.The plane between fusion fascia and anterior lamella of Gerota's fascia, the plane between lateral conal fascia and posterior lamella of Gerota’s fascia, the plane before the quadratus lumborum and psoas major, are all vessel-free planes.Lateral border of colon,peritoneum and fusion fascia form a triangle lateral to colon.Fusion fascia,lateral conal f ascia and Gerota’s fascia form a vessel-free triangle. Conclusions Dissection through the vessel-free planes prevents laparoscopic op erations from bleeding and organ injury.Full understanding of the laparoscopic a natomical features of the retroperitoneal cavity around kidney provides the anat omic theoretical basis for laparoscopic operations.

ObjectiveTo design a new operation approach:extreme lateral transforaminal lumbar interbody fusion (E-TLIF) via digital technology and to discuss its feasibility in treatment of degenerative lumbar diseases.MethodsCT scan image data of lumbar vertebra were obtained from volunteer (a healthy male of 26 years old,67 kg in weight and 172 cm in height).Mimics was used to read and reconstruct the data into 3D images.We observe the anatomical bone structures of intervertebral foramen and nerve roots through CT scan and 3D reconstruction in Mimics to analysis the feature of this area.Then E-TLIF operation,pedicle screw insertion and cage placement were simulated by computer via digital technology in Mimics.The feasibility of this new approach was proved through operating on lumbar of formalin doused body with E-TLIF approach.ResultsAn incision of 9 cm lateral form the central line and 45° from the sagittal plane is operated to fully expose the foraminal area.Remove superior facet while save inferior facet is feasible with this approach in E-TLIF.There is enough room for fully revealing and excision of intervertebral disc,and cage placement through enlarged foraminal area.Digital technology is a more economic,efficient way to design a new operation approach.The results are in accord with the formalin doused body test.ConclusionMimics is an effectively,reliable and economic method to design an operation approach.And the result suggested that E-TLIF is a safe,less minimal invasive and more efficient operation approach in treatment of degenerative lumbar diseases.

Objective To explore the relationship between CRP and glucose metabolism in advanced solid tumor patients. Methods 32 advanced stage malignant tumor patients with mild pain took celecoxib 200mg/qd orally, the plasma level of CRP, FBS, FINS, IR were measured before taking drug and 5 days later. Results CRP is well related with FINS, IR, P level, CRP[(8.17?1.76) mg/L vs (4.37?0.65) mg/L], P(876?123)pmol/L vs (621?145) pmol/L], FINS[(14.23?7.21) ?U/L vs (9.83?3.37) ?U/L] and IR [(3.2?1.01) vs (1.9?0.78)] all were improved significantly after taking celecoxib. Conclusion CRP has some relationship with abnormal glucose metabolism in advanced stage malignant tumor patients, taking celecoxib may improve this abnormal glucose metabolism.

Objective:Expression of protein TSLP and selection of full human anti-TSLP single chain Fv ( scFv).Methods:The cDNA of TSLP was amplified.The amplified target gene and the expression vector pET 101/D-TOPO were ligated , and then transformed into E.coli BL21.The protein was induced to expression by IPTG and purified and identified.The biotinylated TSLP protein was used as antigen to select of human TSLP scFv from a constructed human scFv library by phage display .Results: The size of amplified cDNA of TSLP was about 423 bp,and that of expressed protein was about 26 kD.Dot blot and Western blot results showed that the expressed protein was correct.The constructed human scFv library was enriched for three rounds using biotinylated TSLP as antigen by phage display.ELISA results showed that 35% scFvs had binding activity with TSLP.The scFvs with good binding activity were selected and identified by Western blot and sequencing.Conclusion: The full human scFvs against for TSLP were selected suc-cessfully.

Objective To explore the therapeutic effect and application value of the self-made spinal positioning equipment and percutaneous pedicle screw fixation system in the treatment of thoracic and lumbar fracture. Methods To determine the fractured vertebra and pedicle screws entrance point with spinal positioning equipment, 67 patients with thoracic and lumbar fractures were performed percutaneous pedicle screw fixation by using self-made percutaneous pedicle screw fixation system. By contrasting the perioperative indicators, and imaging indicators, to evaluate the therapeutic effect and application value of the system. Results For the spinal positioning equipment, the location time were (15.85±2.45) min and the location accuracy were 95.03%±3.27%. But for the open reduction internal fixation, the location time were (35.46±5.39) min and the location accuracy were 94.02%±2.95%. There was no significant difference in location accuracy, but were significant differences in location time (P＜0.05). Percutaneous pedicle screw fixation had the same effect on three sides with open reduction internal fixation in vertebral height restore,kyphosis deformity and correction and lumbar spinal stenosis's correction. The perioperative indicators of the preoperative and postoperative grope had significant difference (P＜0.05). There were significant differences in all perioperative indicators between the percutaneous pedicle screw fixation and the open reduction internal fixation (P＜0.05). Conclusion The spinal positioning equipment is helpful to determine the fractured vertebra and pedicle screws entrance point accurately and reduce the radiation. The percutaneous pedicle screw fixation system has the advantage of convenient manipulation and accurate implantation. The system can not only reduce surgical damage and post-operation reaction but also make patients recover quickly and face less complications.

Based on the current status of allocation, demands and utilization of medical care resources and the needs for future development in Shanghai, the overall objectives, principles, key plans of allocation of medical care resources in the 12th Five-years Plan in Shanghai and the leading role of health bureaus at all levels were discussed.

Objective To observe the clinical effect of multimodal analgesia for painless artificial abortion . Methods 150 cases of ASA Ⅰ-Ⅱ pregnancy received painless artificial abortion operation ,no contraindication for all patients,were randomly divided into the five groups ,30 cases in each group,the blank control group (group S):do not use any analgesia measure ,intravenous injection of 0.9% sodium chloride 2mL preoperation;the fentanyl group ( F group ) :intravenous injection of fentanyl 1μg/kg preoperation ;the parecoxib group ( group P ) :intravenous injection of parecoxib sodium 40mg preoperation.The patients were given painless artificial abortion after injection the above drugs.Nerve block group ( N group):the implementation of painless induced abortion operation after sleep in patients with the cervical nerve block ,injection of 1%lidocaine 2 mL.Multimodal analgesia group (group M):intra-venous injection of parecoxib sodium 40mg,fentanyl 1μg/kg,then the implementation method the same as N group . The operation time,anesthesia onset time,recovery time,time of accurate orientation and additional dosage of propo-fol;incidence rate of artificial abortion syndrome ,the incidence rate of uterine contraction pain ,10min,30min,1h,6h pain scores after operation; adverse reaction;satisfaction score of analgesic effect postoperative 24h were observed. Results The additional dosage of propofol in the group S ,group F,group P,group N and group M were (78.45 ± 20.36)mg,(15.55 ±12.33)mg,(16.75 ±13.13)mg,(14.55 ±10.25)mg,(9.35 ±8.27)mg.The incidence rates of uterine contraction pain in the group S ,group F,group P,group N and group M were 30%,10%,10%,10%,0. Compared with group M ,the additional dosage of propofol and incidence rate of uterine contraction pain in the other four groups were significantly increased (t=3.05,1.82,1.84,1.78,χ2 =72.1,68.2,68.2,68.2,all P<0.05). Pain scores after operation 10min,30min,1h,6h in the group S were (6.6 ±1.5)points,(5.6 ±1.4)points,(4.6 ± 1.1)points,(3.6 ±1.4)points.Those in group F were (5.1 ±1.5)points,(4.3 ±1.1)points,(3.1 ±0.9)points, (2.8 ±0.8).Pain scores after operation 10min,30min,1h,6h in the group P were (4.6 ±1.5) points,(4.2 ± 0.9)points,(2.9 ±0.8) points,(2.7 ±0.6) points.Those in the group N were (4.5 ±1.5) points,(4.1 ± 0.8)points,(2.9 ±0.8)points,(2.6 ±0.5).Pain scores after operation 10min,30min,1h,6h in the group M were (2.2 ±0.8)points,(1.9 ±0.7)points,(1.5 ±0.5)points,(1.2 ±0.3)points.Compared with the group M,pain scores after operation 10min,30min,1h,6h in the other four groups were significantly elevated ( t=2.03,1.96,1.86, 1.84,1.98,1.82,1.80,1.76,2.05,1.99,1.95,1.86,2.06,1.88,1.82,1.76,all P<0.05).Compared with S group,postoperative 24h satisfaction score of analgesia in the group M was improved significantly ( t =1.98,P<0.05).Compared with group M,the incidence rate of nausea in the other four groups was increased significantly (χ2 =72.2,68.9,68.1,68.1,all P<0.05).Conclusion Multimodal analgesia method can greatly reduce artificial abor-tion postoperative pain ,reduce the adverse reactions ,improve patients'satisfaction score ,ensure the safety of operation .