Objective To observe the clinical effect of Wangbi tablet oral therapy combined with joint mobilization in the treatment of periarthritis of shoulder, to provide reference for the treatment of periarthritis of shoulder.Methods A total of 136 patients with scapulohumeral periarthritis in our hospital from January 2015 to June 2016 were selected as the research object, according to the order of hospitalized patients were randomly divided into observation group and control group,with 68 cases in each group, the observation group was treated with Wangbi tablet combined with joint mobilization,the control group was treated with single joint mobilization.After treatment, the clinical curative effect,complications or adverse reactions were comparedbetween the two groups, visual analogue scale(VAS)was used to compare the degree of pain of shoulder joint of patients before and after treatment, the shoulder joint function score were compared by the Japanese Orthopedic Association(JOA)'s shoulder disease score, the patients were followed up for a half a year and the Barthel index score was used to compare the daily life ability score of dynamic contrast.Results (1)The total effective rate of the observation group was(64/68), the control group was 82.35%(56/68), the observation group was significantly better than the control group(P<0.05).(2)The incidence of adverse reactions in the observation group was(8/68), the control group was 7.35%(5/68), and the safety of the two groups was good.(3)the VAS score of the observation group was(3.09±0.98), the control group was(4.53±1.02), and the pain of the observation group was significantly lower than that of the control group(P<0.05).(4)After treatment, the JOA score of the observation group was(16.54±2.36), and the control group was(12.97±2.71).The observation group was significantly higher than the control group(P<0.05).(5)The observation group treatment and follow-up of the Barthel index score was(73.11±6.21),(83.89±7.95)points, the control group was(68.41±5.65),(73.88±6.80), the activities of daily living of the observation group were higher than that of the control group(P<0.05).Conclusion There is a significant effect of Wangbi tablet therapy combined with joint mobilization for the treatment of patients with periarthritis of shoulder, the safety of the treatment is high, can reduce the pain of patients, improve the activity of shoulder joint function and activity of daily living, the comprehensive curative effect, with a high clinical value to promote.

Objective To study the improvement of hemorheology and prognosis of vertebral artery type cervical spondylosis by combination of strong Dingxuan tablet.Methods106 cases of vertebral artery type cervical spondylopathy were randomly divided into observation group and control group.Fifty-three patients in each group were treated with manipulation in the control group, and the patients in the observation group were enrolled.The blood viscosity, whole blood low shear viscosity, plasma viscosity, whole blood reduction viscosity, hematocrit, erythrocyte aggregation index, fibrinogen and so on were compared between the two groups before and after treatment.Rheological parameters of the situation, the two groups of patients for 1 year follow-up observation, compared with 1 year recurrence rate.ResultsThe total effective rate was 92.45% in the observation group and 77.36% in the control group (P<0.05).The whole blood low shear viscosity (7.01±1.52) mPa·s, the whole blood viscosity (1.18±0.28) g/L was significantly higher than that in the control group (7.88±1.65) mPa·s, (1.47±0.34) mPa·s, (4.51±0.98) g/L, respectively (P<0.05).The recurrence rate was 13.21% in the observation group and 30.19% in the control group (P<0.05).ConclusionThe combination of strong Dingxuan tablet combined with manipulation of vertebral artery type cervical spondylopathy is significant, the blood viscosity of the patients is reduced, the blood circulation function is improved, the recurrence rate after treatment is low, and it is worthy of clinical application.

[Summary] With the improvement of current medical diagnosis and treatment technology, more and more patients with adrenal hypoplasia congenita and hypogonadotropic hypogonadism have been diagnosed. DAX-1 gene mutation has been accounted for one of the most important reasons. Clinical manifestations include adrenocortical hypofunction such as loss of salt, dehydration, nausea and vomiting, as well as gonad dysplasia of male patients in puberty. The disease can be diagnosed by blood biochemical and hormonal level testings, imaging tests and gene sequencing. Patients can be treated by glucocorticoid, mineralocorticoid, and male sex hormone. The review will expand the diagnosis and treatment of adrenal hypoplasia congenita with hypogonadotropic hypogonadism caused by DAX-1 gene mutation.

Object To investigate the effects of ethanol sediments obtained from the tuber of Angelica sinensis (Oliv). Diels (ESA) and its litmusless component (ESA 1) on the secretion of TNF ? and IL 1 by mice peritoneal macrophages in vitro. Methods L929 cell line cytotoxicity was used for the assay of TNF ?. The proliferation of L929 cell line was used for the assay of IL 1. Results The secretion of TNF ? and IL 1 by mice peritoneal macrophages which were co cultured with ESA or ESA 1 in vitro can be significantly promoted. At the concentrations in range of 5～20 ?g/mL, there is a dose dependence in the action of ESA, while there is not the similar effect of ESA 1, even though it showed the marked effect. Conclusion ESA and ESA 1 can enhance the secreting TNF ? and IL 1 of mice peritoneal macrophages in vitro.

Objective To investigate emergency management strategies and risk factors for mortality of open pelvic fractures associated with anorectal injuries.Methods Between April 2001 to April 2010,25 patients of open pelvic fractures associated with anorectal injuries were admitted to Shandong Provincial Hospital and Laigang Hospital,and early emergency treatments of this injury were retrospectively studied.Of these 25 patients,23 were male and the remaining 2 were female,and the mean age was 30.1±10.9 years (range,16-56 years).Fisher's exact test and multivariate logistic regression analyses were used to determine the risk factors related to mortality caused by this injury.Results Of the 25 patients,19 survived,other 6 patients were dead.The overall mortality was 24%.Fisher's exact test identified that the following risk factors including Tile classification,ISS,GCS and RTS were associated with the injury mortality.Patients with Tile C pelvic fracture ,ISS ≥ 25 points,GCS≤8 points or RTS≤8 points had a high probability of resulting in death.Multivariate logistic regression analysis was performed with the four variables noted above,and the results demonstrated that RTS ≤ 8 points was the only independent risk factor for mortality of patients with this injury.Conclusion Stabilization of hemodynamic condition,aggressive debridement and irrigation of the wound,early diversion of the fecal stream and early stabilization of pelvic fracture are critical strategies for the emergency management of open pelvic fractures associated with anorectal injuries.Furthermore,based on our findings,it can be concluded that RTS≤8 was reliable for predicting the probability of death in patients with this injury.

Objective To explore the influence of the number and orientation of the beams on the optimization of IMRT plan.Methods Four IMRT plans were designed for 9 patients with cervical cancer,and 7 and 15 fields were applied.The 15-field plans had 30 segments and the 7-field plans had 55 segments.The initial beam angle degrees were 0° and 180°,respectively.Dose delivery time,MUs of plans,the dose distributions of the targets,organs at risk and normal tissues were analyzed and compared in the plans.Results Compared the plans with different beam directions under the same amount,no difference of the irradiation dosimetry in the target and organs at risk was found,except for irradiation dosimetry received by the 7-field 180° small intestine was about 4％ higher than the other three plans(F=6.164,P＜0.05).The terms of the volume of organs at risk got high dose irradiation(V40 and V30 of the rectum and bladder,V40 of the small intestine),which was similar in the 7-and 15-field plans.V20 and Dmean of organs at risk were significantly smaller(F=3.665-10.503,P＜0.05)in the 15-field plans.The 15-field plans needed a little longer treatment time(F=0.312,P＜0.05)and HI was slightly worse (F=12.933,P＜0.05),but the number of MUs was significantly reduced(F=4.650,P＜0.05).Conclusions Increasing the beam number will offset the negative impact of sub field reduction and get the similar dose distribution result.

Objective To investigate the genotypic characteristics of hepatitis B virus(HBV) in Tibet.Methods Serum samples from 60 cases of hepatitis B in Tibet Autonomous Region were collected from January 2000 to March 2004.HBV genotypes were analyzed by sequencing S region and precore/core region.Results HBV isolated from 60 cases were all found to be D genotype by S region sequencing.Dc mixture was found in 59 cases,showing the recombination between their precore/core gene and genotype B virus at 1804-2299 nucleotide.The other one case showed Dbc mixture genotype,showing recombination between its precore/core gene and genotype B and C genes.Conclusions All Tibet cases in this study show mixture genotype D with recombination with genotvpe C or both genotype B and C at precore/core region.No case of pure genotype D is found.

ObjectiveTo investigate fecal diversion in the management of pelvic fractures associated with perineal injuries.MethodsThis retrospective study involved 27 patients of pelvic fractures associated with perineal injuries during April 2005 to April 2011.There were 23 males and 4 females,and the mean age was 32.9 years old (range,16-62 years old).Fractures type according to Tile classification:4 cases were type A,10 cases were type B,and 13 cases were type C.The pelvic external fixator and fecal diversion were selectively used.Results Of the 27 patients of pelvic fractures associated with perineal injuries,24survived.The overall mortality of pelvic fractures associated with perineal injuries in the present study was 11％.The survived 24 patients were totally reviewed clinically.The mean follow-up time of these patients was 10.9 months (range,4-42 months).Of those patients who underwent early fecal diversion (＜ 48 h),none experienced infectious completions.However,of those underwent non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion),four patients experienced infectious completions.Fisher's exact test was used to compare the infection rate of these two groups.And the result of Fisher's exact test demonstrated that those patients who underwent early (＜ 48 h) fecal diversion and non-early (＞48 h) fecal diversion (including those who did not undergo fecal diversion).ConclusionStabilization of hemodynamic; selective fecal diversion; early stabilization of pelvic fracture are necessary for the emergency management of pelvic fractures associated with perineal injuries.Rectal injury and severe perineal injury without involvement of rectum should undergo fecal diversion.Early fecal diversion (＜ 48 h) could reduce the infection rate of pelvic fractures associated with perineal injuries.

Objective To investigate the clinical value of gauze packing for haemodynamically unstable pelvic fracture.Methods Between January 2006 and January 2014,gauze packing was used to treat haemodynamically unstable pelvic fracture in 42 patients consisting of 23 males and the 19 females aged 34.2 years (range,18 to 54 years).AO classification of the fracture was type B1 in 9,B2 in 5,B3 in 3,C1 in 13,C2 in 4,and C3 in 8 patients.All the patients were diagnosed with hypovolemic shock upon admission with the systolic pressure of (75.4 ± 4.3) mmHg and heart rate of (126.5 ± 12.4) beats/ min.Injury severity score (ISS) was (38.7 ± 6.2)points.Anti-shock treatment,internal or external fixation of pelvic ring,and gauze packing were performed immediately to control the hemorrhage following pelvic fracture.Results Systolic pressure was (95.2 ± 4.6) mmHg and mean heart rate was declined to (85.4 ± 13.2)beats/min after pelvis volume control and gauze packing,with significant differences compared to these preoperatively (P ＜ 0.05).Red blood cell transfusion before internal or external fixation and gauze packing was (15.0 ± 2.4) units versus (8.3 ± 1.5) units within the first postoperative 24 hours (P ＜ 0.05).Twenty-four out of the 42 patients underwent temporary abdominal aorta occlusion.Six patients died postoperatively with the death rate of 14％.Mean time of removing the packing gauze was (51.4 ± 10.3) hours (range,24-168 hours).Conclusion Anti-shock treatment with concurrent gauze packing and pelvis volume control is effective to arrest the massive hemorrhage in hemodynamically unstable pelvic fracture.

OBJECTIVE:To establish microbial limit test for Compound clindamycin hydrochloride gel and to carry out the validation of three methods.METHODS:According to the appendices volumeⅡof Chinese Pharmacopeia(edition 2005),microbial limit test which contained routine test,medium dilution method and membrane-filter method was adopted to validate Compound clindamycin hydrochloride gel.Recoveries of three methods were compared to make sure the suitable validation method.RESULTS:In routine test,recovery of trial bacteria was lower than 70%and controlled bacteria couldn't be found out.In medium di-lution method,recovery of trial bacteria was higher than 70%and still lower than the recovery of diluents.In membrane-filter method,recovery of trial bacteria was higher than 90%,and controlled bacteria grew well.Membrane-filter method could eliminate inhibition effect of Compound clindamycin hydrochloride gel on bacteria.CONCLUSION:Membrane-filter method is effective and practical for microbial limit test of Compound clindamycin hydrochloride gel.