Severe clubfoot has complicated clinical features.Conventional surgical management could hardly get satisfactory results,always with serious trauma,and even smaller foot.This paper summarizes the characteristics of clubfoot in details and its relative assessment standard,principles and advantages of Ilizarov's technique,design of the apparatus and correction procedures.Combination of this and traditional technique and reasonable osteotomy method are also analyzed,complications are discussed for prevention.

Four diterpenoid alkaloids were isolated from Aeonitum longtounens T. L. Ming grown in Lijiang of Yunnan Province, for the first time. They were identified as foresaconitine, chasmaconitine, delsoline and delcosine by Physical contants and spectral data.

The present paper reports the distribution of ALADH phenotypes in 170 Chinese peoples living in Nanjing area by means of the mixed starch get electrophoresis. The gene frequencies are ALADH~1=0. 359, ALADH~2=0.641, which are compared with the gene frequencies of some other countries.

Objective To define the risk period of acute pancreafifis-associated lung injury (APALI) by aserial study including a dynamic changes in total water content of lung, ultrastructure and number of type Ⅱ alveo-lar epithelial, and reactive oxygen metabolisms (ROMs) of lung tissue in mice with severe acute pancreatits (SAP)and a clinical analysis of APALI patients. Method ICR mice were selected to establish SAP model. The animalsreceived 7 intraperitoneal injections of caerulein (50 μg/kg body weight) at hourly intervals followed by intraperi-toueal injection of lipopolysaccharide (15 mg/kg body weight). The total water content, uhrastrueture and numberof type Ⅱ alveolar epithelial cells, and ROMs of lung tissue were detected before (0 h) and 6 hours, 12 hours,lday, 4 days and 7 days after SAP model establishment, respectively. In addition, 215 patients with APALI (PaO2< 60 mmHg) collected from the First Affiliated Hospital of Zhejiaug University between January 1998 and Decem-ber 2006 were analyzed. Statistical analysis were performed by using F-test. P-values less than 0.05 were regardedas statistically significant. Results The total water content and ultrastructure mitochondria and lamellar bodies intype Ⅱ alveolar epithelial cells of lung in SAP mice were significantly altered at 12 hours after SAP model estab-lishment, and reached maximum at 1 to 4 days later. A decrease in number of type Ⅱ alveolar epithelial cells andincrease in ROMs reached a maximum at 1 day after SAP model establishment. Furthermore, the results of clinicalstudy showed that the lung injury occurred at (3.1435±1.0199) days after SAP. The data were almost consistentwith the resalts from SAP model. Conclusions The risk period of APALI occurres between the 1st day and the4th day during the course of SAP.

Objective To introduce a new computer-assisted external frame for osteotomy to correct complex tibial and fibular deformity.Methods From January 2012 to December 2013,15 patients with complex tibial and fibular deformity were treated with a computer-assisted external frame and related computer software for surgical correction.All were unilateral limb deformity,involving the left lower limb in 8 cases and the right lower limb in 7 cases.They were 8 males and 7 females,15 to 43 years of age (average,26.8 years).The deformity was caused by old osteomyelitis in 9 cases and trauma sequela in 6.The related angles,distances and rotations were measured on the postoperative radiographs of the lower limbs.The data were input into the software to calculate the daily adjustment lengths of the frame rods.Daily frame adjustments were conducted according to the data calculated.The frame was removed when expected results were achieved.The patients lived independently during the adjustment.Results The 15 patients were effectively followed up for 10 to 22 months (average,15 months).Frame fixation time averaged 8.4 months (from 5.5 to 13.1 months).The reunion time averaged 8.0 months (from 5.4 to 12.1 months).The hospitalization time averaged 2.4 months (from 2.0 to 2.8 months).In 10 cases of limb shortening,the shortening lengths averaged 0.5 cm (from 0 to 0.9 cm) after adjustment.In 12 cases of angulation deformity,the angulation averaged 3.3° (from 0° to 5.4°) after adjustment.In 5 cases of rotation deformity,the maximum internal rotation was 5° and the maximum external rotation 10° after correction,deviating from the normal values by 3.5° on average.In 6 cases of horizontal displacement,the displacements averaged 0.5 crn after correction.All patients were satisfactory with corrected lower limb alignment,improved symptoms and appearance,giving a subjective satisfaction rate of 100％.Conclusion Use of computer-assisted external frame in surgical correction of tibial and fibular deformity can achieve satisfactory outcomes in simple,accurate,standardized,minimally invasive manners.

Molecularly imprinted polymer (MIP) was synthesized by precipitation polymerization using ribavirin as the template molecule and methacrylic acid as the functional monomer.The sensitive film of ribavirin electrode was constructed by molecularly imprinted polymer doped with graphene oxide as the ionophore, poly(vinylchloride) (PVC) as matrix and dioctyl sebacate for plasticizer.The results showed that the best performance of the electrode was obtained when the sensitive film compositions were 100.8 mg of MIP, 14.7 mg of GO, 450.8 mg of PVC and 901.6 mg of dioctyl sebacate, and the inner filling solution composition was 0.1 mol/L NaCl + 0.05 mol/L NaAc-0.05 mol/L HAc + 1.0×10.-5 mol/L ribavirin solution.The electrode showed a near-Nernstian slope of 45.565 mV/decade for ribavirin over the range of 1.0×10.6-1.0×10.-4 mol/L and a detection limit of 1.0×10.-7 mol/L.The electrode could be used in the pH range of 3 to 5 with response time of less than 3 min.The developed electrode exhibited high selectivity for ribavirin and was successfully applied to the determination of ribavirin in feed and injection with recoveries of 90%-110% and RSD of 3.0%-7.9%.

OBJECTIVE:To understand the situation of essential medicines and promote their rational use in our hospital. METHODS:The prescription variety and cost percentages of essential medicines in outpatient department in the two halves years of 2013 in our hospital(eye and ENT specialized hospitals)were compared;the medicines with forefront prescription kind percent-ages in eye and ENT departments were sorted and rankings in 4 quarters were compared. RESULTS:After the approval of the Na-tional Essential Medicine List(2012 edition),compared with the first half year of 2013,prescription variety and cost percentages of essential medicines in outpatient department in the second half year were significantly increased (P<0.01). Prescription variety and cost percentages of essential medicines in eye department in the second half year were significantly increased(P<0.01),in the top 20 prescription variety,totally 2 kinds were contained by the list 2012 edition and 3 were contained by the supplementary list of Shanghai(2012 edition). Compared with the first half year of 2013,prescription variety and cost percentages of essential medi-cines in ENT department in the second half year were significantly decreased(P<0.01),the cost percentage was significantly in-creased(P<0.01),in the top 20 prescription variety,totally 2 kinds were contained by the list 2012 edition and 3 were contained by the supplementary list of Shanghai (2012 edition). CONCLUSIONS:The prescription variety and cost percentages of essential medicines in our hospital show increase trend. Nevertheless,the non-essential medicines are still dominant and further improvement of essential medicines is still needed. Medicine variety and dosage forms of eye in ENT department are insufficient concluded in Es-sential Medicine List. Further adjustment of Essential Medicine List still needs more consideration for the medication characteristics in specialized hospital.

In order to arouse the working enthusiasm of the entire staff and give expression to the value of labor and skills, our hospital has implemented reform in the distribution system. Bonus given to clinical departments is linked both to the amount and quality of work and to economic profits; bonus to medico technical departments is given by means of deducting a percentage from the income and expenditure surplus in a way of progressive decrease; bonus given to functional departments is equivalent to 90% of the average bonus given to medical service departments; and bonus to logistical service departments is given, if possible, by the piece and mark. As a result of the reform, the distribution system has become more rational, the working enthusiasm and efficiency of the staff have been enhanced, operational income and income structure have improved, and social benefits bave been raised, with the satisfaction rate reaching over 90%. Of course, there still exist some difficulties in the reform.

ObjectiveTo evaluate surgical management of femoral pseudoaneurysm caused by injection of addictive drugs.MethedsData of 18 cases were reviewed and analysed retrospectively.13 patients underwent primary expanded polytetrafluoroethylene(ePTFE) external iliofemoral bypass (end to side) grafting. Postoperative anastomotic burst and bleeding in one of the 3 patients undergoing saphenous vein autotransplant in situ was successfully treated by ePTFE grafting. Results All of the grafts were patent as demonstrated by postoperative color Dopler ultrasonography. Although 2 patients had their femoral arteries ligated, limbs of all the 18 patients were salvaged.ConclusionsWhen a suitable saphenous vein is not available for autotransplantation, an artificial vessel grafting is still an effective procedure for managing femoral artery false aneurysm.During operation thorough debridement and avoidance of artificial vessel contamination are the most important factors for preventing infective complications of the graft.

[Objective]To study the safety,clinical effect and therapeutic characteristics of distraction apparatus for correcting flexion contracture deformities of the knee joint by evaluating the clinical outcomes and investigating the results of biomechanic test.[Method]Forty-nine patients (included 52 knees) were treated by the standardized distraction apparatus and the comprehensive assessment standard was adopted to evaluate the clinical outcomes.Five patients were examined by three-dimensional CT of the knee joints pre-operatively and post-operatively to observe the changes in the knee structure.To observe the effect of distraction on the popliteal artery and the limb nerves,the popliteal artery diameter and blood flow speed were examined in 15 patients and the regio cruris electromyogram and nerve conduction velocity were examined in 6 patients before and after treatment.Three different means of distraction and measurement were underwent in 3 patients so as to observe the changes in the flexion curve and force of posterior soft tissues of the knee.[Result]All patients (52 knees) regained congruous structure and better function,the final excellent and good result rate was 65%.Three-dimensional CT examination of 5 patients showed that the postoperative knee joint structures were superior to the preoperative ones and there weren't damage of articular surface.The statistic results indicated that the popliteal arteries weren't obviously disturbed by distraction,whereas the limb nerves were probably disturbed temporarily.Three methods of distraction and measurement in 3 patients showed different outcomes,indicating that the effect of distraction on soft tissues was influenced by the distraction method,the ages of patients and the extents of deformities of the limb.[Conclusion]The distraction speed of therapeutic method is safe,reasonable and effective in correcting flexion contracture of the knee joint;The distraction force on posterior soft tissues of the knee is influenced by various elements,thus,the distraction speed should be individualized.Low-load and steady stretch are advantageous to soft tissue regeneration and safer.