Patients who suffer from recurrent patellar dislocation frequently complain of diffuse pain around the knee, swelling and dislocation or subluxation of the patella. Anatomical abnormalities should be responsible for the condition, such as increased Q angle, a high-riding patella, dysplasia of the femoral condyles, abnormal shape of the patella, atrophy of the vastus medialis and hypertrophy of the vastus lateralis. We reviewed 45 reports about the treatment of recurrent dislocation of the patella. The current more than 100 methods can be classified as: lateral release, proximal realignment, distal realignment, proximal and distal realignment, patella-tomy and plastic repair of quadriceps. Of all these methods, proximal realignment is the best, but there has been no method which can successfully and generally repair the recurrent patellar dislocation.

Objective To evaluate the effect of enteral nutrition emulsion on the immunologic function and intestinal mucous barrier in diabetic patients. Methods Eighty diabetic patients were randomly divided into con-trol group (n=40) and enteral nutrition group (n=40). The urine lactulose (L) and mannitol (M) levels and the blood immunologic indicators recorded on day 1 and day 8. Results The L/M ratio was significantly lower in enteral nutrition group than in control group on day 1 and day 8 ( P < 0. 05 ). The IgG level was significantly higher in enteral nutrition group than in control group on day 8 ( P = 0. 02 ). Conclusion Enteral nutrition emulsion can decrease the permeability of intestinal mucous membrane and improve the immunologic function in diabetic pa-tients.

Objective To investigate the clinical value of the bedside color Doppler in the assessment infants with periventricular-intraventricular hemorrhages (PIVH).Methods Sixty-eight cases of PIVH newborns and 156 healthy newborns were involved in the study,dynamic monitoring were undergone within a week after birth.The middle cerebral artery(MCA) hemodynamic parameters of velocity systolic (Vs),velocity diastolic(Vd) and resistance index (RI) were recorded,and the differences of the parameters were compared between different grades as well as those of the normal newborns at 1 d,4 d and 7 d after born.Results Total 68 PIVH infants were diagnosed by bedside color Doppler accurately.Prevalences of premature and low birth weight infants were higher than term infants and normal birth weight children,respectively (P ＜0.05).Vs and Vd of 4 groups of children with PIVH showed an increasing trend in a week after born.The differences of Vs between grade Ⅰ and normal newborns in 4 d and 7 d were not statistically significant (P＞ 0.05),the differences of the other three groups compared with normal newborn group in1 d,4 d and 7 d were statistically significant (P ＜0.05).Vd of grade Ⅱ newborns within 7 d were greater than those of other 4 groups (P ＜0.05),grade Ⅲ and grade Ⅳ within 7 d were less than healthy newborns (P ＜0.05).The difference of RI between all groups were not statistically significant (P ＞ 0.05).Conclusions The diagnostic accuracy rate of PIVH by bedside Doppler is high and the dynamic monitoring of neonatal hemodynamics could provide an important basis for assessing the occurrence and development of PIVH.

BACKGROUND:Hepatic vascular exclusion is important for liver transplantation that can reduce blood loss and make for liver recovery. A variety of favorable hepatic vascular exclusion techniques occur in the development of liver surgery technology, which is stil a research hot in surgical study. OBJECTIVE:To introduce the latest research and the hot spot of hepatic vascular exclusion techniques. METHODS:A computer-based online search of PubMed and Wanfang databases for articles relevant to Pringle maneuve, total hepatic vascular exclusion, selective hepatic vascular exclusion and sectional vascular exclusion under hepatectomy published from January 1999 to January 2014. Totaly 50 articles were included in result analysis. RESULTS AND CONCLUSION:There are a variety of hepatic vascular exclusion technologies, and intermittent hepatic vascular occlusion and semihepatic vascular exclusion are used most commonly. The applicable principles are as folows: (1) Surgery without vascular exclusion is suitable for < 5 cm lesions at the liver edge. (2) Semi-hepatic vascular exclusion is fit for semi-hepatic lesions, especialy for patients accompanied by liver cirrhosis. Hepatic vascular exclusion with preservation of semi-hepatic artery and liver hanging maneuver are also reported to have a certain value in clinical practice stil need further studies. (3) Intermittent hepatic vascular exclusion is suitable for lesions over half a liver or spanning liver halves (huge lesions). (4) Total hepatic vascular exclusion and its modified technologies are suitable for lesions involving the inferior vena cava and (or) hepatic vein, or lesions closely related to the second and third porta hepatis. (5) Segmental hepatic vascular exclusion is considered for smaler lesions confined to the liver segment under alowed conditions, but semi-hepatic vascular exclusion and Pringle maneuver can be also considered. Depending on patient’s conditions, to select the appropriate method is the key to reduce bleeding and to ensure patient safety.

Problems such as detached knowing and doing , utilitarian tendency , moral practice ability is weak and so forth are now existing in the medical college students'moral practice in the new period .There are not only medical students'personal factors , but also school and social factors .Therefore , it should excavate potential , build good medical students moral practice platform , innovative form of moral practice , motivate medical students to par-ticipate in the moral practice enthusiasm , strengthen the construction of management system , ensuring the medical students moral practice into effect .

Objective To establish a HPLC method for the determination of the content of emodin and chrysophanol in Cigu Xiaozhi pill.Methods The chromatographic procedure was carried out in Symmetry C18(4.6 mm?150 mm,5.0 ?m) column with methanol-0.1% phosphoric acid(85∶15) as the mobile phase,flow rate was 0.8 mL/min,column temperature was 20 ?C,and the detection wavelength was 423 nm.Results Emodin and chrysophanol were well separated with other components.The standard curves of emodin and chrysophanol showed linearity in the range of 0.25～0.75 ?g.The average recoveries were 101.35%(RSD=2.26%) and 98.66%(RSD=1.74%) respectively.Conclusion The method is sensitive,simple and accurate,and can be used for the determination of emodin and chrysophanol in Cigu Xiaozhi pill.

[Objective]To evaluate the outcome of thoracolumbar fracture with spinal cord injury treated with short-segment pedicle instrumentation.[Method]47 cases of thoracolumbar fracture with spinal cord injury from 1999 to 2004 in our department were collected,all of them were treated with short-segment pedicle instrumentation.The radiologic,neurologic,and functional outcome were assessed.[Result]All of the 47 cases were followed up,the mean follow-up were 51.9 months(18~ 86 months),the average of vertebral anterior and posterior height were corrected from 43.6%,71.4% to 92.2%,96.4%;and 88.3%,93.1% at the last follow-up separately.The Cobb's angle were corrected from 23.5?to 4.3?,and 8.8? at the last follow-up.62.8% of the vertebral canal was occupied pre-operation,and 11.4% post-operation,6.2% at last follow-up.There was significant deference in targets between pre-operation and post-operation(P0.05).Neurologic status improved at least 1 Frankel grade in the patients who had preoperative incomplete paraplegia.61.7% of patients returned to work.[Conclusion]Short-segment pedicle instrumentation can provide good reduction,strong fixation,complete decompression and fusion.The treatment outcome is good.Moreover,it is a less traumatic,simple and safe technique.

Object Isolation and structural determination of the chemical constituents from the 95% ethanol extract of the pericarp of Sphaerophysa salsula (Pall.) DC. Methods To isolate chemical constituents, solvent extraction together with column chromatography was used. Physico-chemical characters and spectroscopic analysis were employed for structural identification. Results Four compounds were identified as 5?-stigmast-3-one (Ⅰ), 5?-stigmast-3, 6-dione (Ⅱ), stigmast-4-en-3-one (Ⅲ), 3?, 6?-stigmast-4-en-3, 6-diol (Ⅳ). Conclusion All these compounds were first isolated from the plants of Sphaerophysa DC.

Objective To compare diffenrent amounts of the glycyrrhizic acid extracted by two methods-decoct method and Ammonia-water method.Methods The best extraction conditions including amount of affusion water and solvent,extraction time,boiling time,crash time,vibrating time and concentration of ammonia were choosed by orthogonal design.Amounts of the glycyrrhizic acid were determined by ultraviolet spectrophotometry at 252 nm wavelengh.Result The best extraction conditions from decoct method were that amount of affusion wate was 200 mL,extract 2 times,boiling time was 5 min,crash time was 20 s.The best extraction conditions from Ammonia-water method were that amount of 0.4% ammonia was 200 mL,vibrating time was 2 h,extract 2 times.The extraction rate of Ammonia-water method was 32%,and the extraction rate of decoct method was 26%.Conclusion For glycyrrhizic acid extraction and purity,Ammonia-water has superior efficient than decoct method at the best conditions.

Objective To establish an RP-HPLC method for the determination of the content of safflor yellow A in Zhanjing Tinctura. Methods The chromatographic procedure was carried out in Symmetry C18 column(4.6mm?150 mm,5.0?m)with methanol-water-glacial acetic acid(7:93∶2)as the mobile phase,pH=2.80. The flow rate was 1.0 mL?min-1,column temperature was 20℃,and the detection wavelength was 402 nm. Results Safflor yellow A was well separated from other components. The standard curves of safflor yellow A showed linearity in the range of 0.096～0.960?g (r=0.9999). The average recovery was 98.80% with RSD being 2.95%(n=9). Conclusion This method is sensitive,simple and accurate,and can be used for the determination of safflor yellow A in Zhanjing Tinctura.