Sepsis is a life-threatening organ dysfunction caused by dys-regulated host response to infection. Acute kidney injury (AKI) caused by sepsis is one of the most common and severe clinical disease, which incidence and mortality remains high level, and has poor clinical outcomes. Continuous renal replacement therapy (CRRT) is an indispensable tool for the treatment of critically ill patients with severe AKI, but there is no consensus on the appropriate treatment dose of CRRT. By reviewing the process of high volume hemofiltration (HVHF) and standard volume hemofiltration (SVHF), comparing their benefits and risks, and making suggestions for therapeutic schedule improvement, reference for clinical work was provided.

OBJECTIVE:To establish a method for simultaneous determination of pulchinenoside B4,caffeic acid,baicalin, palmatine hydrochloride and berberine hydrochloride in Baipuhuang tablets. METHODS:HPLC method was adopted. The determi-nation of Agela Technologies Venusil XBP C18(L)with mobile phase consisted of acetonitrile-0.05 mol/L monopotassium phosphate (gradient elution)at the flow rate of 0.8 mL/min. The detection wavelengths were set at 203 nm(pulchinenoside B4)and 323 nm (caffeic acid,baicalin,palmatine hydrochloride,berberine hydrochloride). The column temperature was set at 30 ℃,and the sam-ple size was 10 μL. RESULTS:The linear ranges were 0.08141-8.141μg for pulchinenoside B4(r=0.9998),0.01871-1.871 μg for caffeic acid (r=0.9994),0.03733-3.733 μg for baicalin (r=0.9992),0.02885-2.885 μg for palmatine hydrochloride (r=0.9996) and 0.02758-2.758 μg for berberine hydrochloride (r=0.9997). The limits of quantitation were 0.009,0.006,0.008, 0.011,0.013 ng,respectively. The limits of detection were 0.030,0.020,0.025,0.034,0.036 ng,respectively. RSDs of preci-sion,stability and reproducibility tests were all lower than 2.0%. The average recoveries were 97.39%-102.34%(RSD=1.81%,n=6),96.77%-98.92%(RSD=0.85%,n=6),97.38%-103.72%(RSD=2.46%,n=6),96.73%-102.01%(RSD=2.22%,n=6)and 96.47%-101.07%(RSD=1.61%,n=6),respectively. CONCLUSIONS:The method is simple,accurate and reproducibility,and can be used for simultaneous determination of pulchinenoside B4,caffeic acid,baicalin,palmatine hydrochloride and berberine hy-drochloride in Baipuhuang tablet.

Objective To detect the preliminary results of combined periacetabular and intertrochanteric osteotomies for complex hip dysplasia.Methods From January 2006 to August 2011,23 patients (25 hips) with complex hip dysplasia were treated with combined periacetabular and intertrochanteric osteotomies (ITO).Valgus ITO was performed on 2 hips and varus ITO on others.The averagc age of patients at the time of index procedure was 20.5± 3.9 years (range:15 to 26).The hip pain period before surgery varied from 5 to 24 months (mean 11±4.7 months).The Shenton's line was broken in every hip and the mean preoperative lateral central edge angle (LCEA) was 5.6°±4.6°.The average preoperative fenoral neck-shaft (CCD) angles were 158°±3.2° and 110° in 23 valgus hips and both of two varus hips respectively.The preoperative Harris hip score was 76.7±3.7.According to T(o)nnis osteoarthritis grades,there were 7 hips at grade 0,12 hips at grade Ⅰ and 6 hips at grade Ⅱ.Results The mean followup period was 40±18 months (range:12 to 78).The CCD angle (130°±2.1°),LCEA (28.6°±2.9°) and Harris hip score (90.8±3.3)were all improved postoperatively,whereas no progression was found in preoperative T(o)nnis grades.The postoperative Harris hip scores were excellent in 17 hips and good in 8 hips.The T(o)nnis osteoarthritis grades were grade 0 in 6 hips,grade Ⅰ in 11 hips and grade Ⅱ in 8 hips.There wcre six cases with lateral femoral cutaneous nerve injury,three cases with limp and two cases with broken Shenton's line.Neither femoral head necrosis nor bone nonunion was found in this study.Conclusion Satisfactory preliminary results could be obtained through combined periacetabular and intertrochanteric osteotomies among patients with complex hip dysplasia.The risk of femoral head necrosis and bone nonunion was low.

BACKGROUND:Some scholars suggest that the nerve root palsy after cervical spinal stenosis treated with
decompression and implant internal fixation is related with the cervical stability and cervical lordosis, but there is controversial.
OBJECTIVE:To explore the C 5 nerve root palsy and stability after cervical spinal stenosis treated with posterior laminectomy lateral mass fixation and single-door decompression laminoplasty.
METHODS:Twenty-nine cervical spinal stenosis patients were selected and treated with posterior
decompression and implant internal fixation. Posterior laminectomy lateral mass fixation for the treatment of
cervical spinal stenosis:C3-6 lateral mass and C7 pedicel screw internal fixation was performed and caused rough surface on the facet joint;the unstable segment was confirmed according to the preoperative anteraposterior
plain film and dynamic radiographs combined with MRI and CT images, and then the corresponding segments were treated with lateral mass internal fixation, single-door decompression laminoplasty and laminoplasty.
RESULTS AND CONCLUSION:Al the 29 cervical spinal stenosis patients were fol owed-up for 8 months to 2.3 years. Among them, 14 cases were treated with posterior laminectomy lateral mass fixation, two cases had nerve root palsy in the early stage after implantation, three cases had incomplete paralysis after long-term symptom recurrence and treated with second surgery of scar remove and decompression;15 cases were treated with single-door decompression
laminoplasty, and one case had C 5 never root palsy and shoulder abduction dysfunctionafter treatment, no preoperative symptom recurrence. The nerve root palsy wil restored in 6 weeks for shortest and 9 months for longest. As the limitation of the case number, it is not clear whether there were significant differences in the correlation between C 5 nerve root
palsy and segmental stability, cervical lordosis, spinal decompression degree and the range for spinal cord shift, as wel as the nerve root palsy degree and the cervical spinal stenosis recurrence caused by forward scar between two
treatment methods, so accumulation observation of the cases and clinical experience are needed.

Objective To investigate the diagnostic significance of endoscopic ultrasonography (EUS) for suspected choledocholithiasis in non-cholangiectasis. Methods EUS was performed on 33 patients with cholecystolithiasis, whose common bile duct diameters were less than 8 mm, with one of the histories of acute pancreatitis, obstructive jaundice or recurrent biliary colic, but without common bile duct stone (CBDS). The results were compared with surgical or ERCP findings. Results Twenty cases in 33 were diagnosed ascholedocholithiasis by EUS. Sixteen of the 20 cases were confirmed as CBDS with further operation or ERCP. Compared with the results of surgery or ERCP, the sensitivity, specificity, positive prediction value and negative prediction value of EUS for choledocholithiasis were 100% , 76. 5% , 80% and 100% respectively. Conclusion EUS is of high diagnostic significance for suspected choledocholithiasis in non-cholangiectasis.

Objective:To establish the HPLC fingerprint of ethanol parts of compound Sanhuang tincture ( an anti-infective drug) using high performance liquid chromatography, and analyze the classification of the chemical components. Methods: A Phenomenex Luna C18 (2) (250 mm × 4. 6 mm, 5 μm) column was used. The mobile phase was acetonitrile-0. 05 mol·L-1 aqueous potassium di-hydrogen phosphate solution (22 :78) and the flow rate was 1. 0 ml·min-1 . The DAD detector was used and the detection wavelength was 237 nm. The column temperature was 30 ℃ and the injection volume was 10 μl. Results:The fingerprints of compound Sanhuang tincture were obtained with promising separation degree and the number of theoretical plates. A total of six fingerprint characteristic peaks were identified, and the reproducibility, stability and precision of the method were good. Meanwhile, combined with the informa-tion of retention time of compound medicine, single drug and reference substance, the source of characteristic peak of the effective part of compound Sanhuang tincture was determined. Conclusion:The fingerprints of compound Sanhuang tincture have strong characteris-tics and good reproducibility, which have important reference value for the quality evaluation of ethanol parts of compound Sanhuang tincture.

ObjectiveTo report the preliminary results and surgical technique of Stoppa approach used in treatment of acetabular fracture.MethodsFrom May 2005 to May 2010,23 patients with acetabular fracture were treated using modified Stoppa approach.The mean age was 37 years old(range,21-71years old).According to Letournel classification,there were 7 cases in anterior column fracture,6 cases in anterior column with posterior hemitransverse fracture,6 cases in transverse fracture,4 cases in associated with both column fractures.All patients in the study were operated under general anesthesia on a radiolucent table in a supine position and underwent Stoppa approach.Fracture reduction was evaluated by Matta's score system.The clinical outcome was judged by modified Merle d' Aubigne and Postel score system.Four cases of associated both column fractures,4 cases of anterior column with posterior hemitransverse fracture required the use of the lateral window.ResultsThe mean surgical time was 166 min (range,110-320 min).The mean blood lose was 647 ml (range,300-2500 ml).Blood transfusion was 3.3 unites (0-12 unites).All the factures healed in 3 months.The fracture reduction was evaluated according to the Matta's score system:an excellent reduction was obtained in 15 patients(65％),a good reduction was obtained in 5 patients (22％),and three(13％) were considered poor.Clinical results were excellent in 11 patients(48％),good in 7 patients (30％),fair in 3 patient (13％),and poor in 2 patients (9％).Superficial wound infection happened in 1 case.It healed after debridment.One patient noted to have significant weakness of the hip adductors (obturator nerve palsy) after surgery.It reached grade Ⅳone year later.No sciatic nerve,femoral nerve and vascular injury happened in this study.ConclusionFor the selected acetabualar fracture,Stoppa approach can get satisfied exposure and fixation of the fracture,especially in the patient with central dislocation of the femoral head as well as medial displacement of quadrilateral plate.

Objective To investigate the detection and clinical significance of thrombus molecular markers in diffuse large B-cell lymphoma (DLBCL). Methods We collected the blood specimens of 60 patients with DLBCL, involving 23 cases in the initial treatment group, 24 cases in the remission group and 13 cases in the non-remission group, 23 cases in the thrombus group and 37 cases in the non-thrombus group. We selected 46 healthy people in the same period as the control group. The levels of thrombomodulin (TM), plasmin-α2 plasmin inhibitor complex (PIC), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC) and thrombin-antithrombin Ⅲ complex (TAT) in plasma were detected by chemical immunoassay, and the levels of lactate dehydrogenase (LDH) in serum was detected by automatic biochemical analyzer. We analyzed the differences of thrombus molecular markers among groups and prognostic factors. Results The levels of TM and PIC in plasma of lymphoma patients were higher than those in health control group (P < 0.05). The levels of TM and PIC in the initial treatment and non-remission groups were significantly higher than those in the remission group (P < 0.05). The levels of TM, PIC and TAT in thrombus group were higher than those in non-thrombus group (P < 0.05). TM and PIC levels in plasma were closely related to the prognosis of DLBCL patients. PIC was an independent prognostic factor (P < 0.001). TM and PIC levels were correlated with LDH prognostic indicators in lymphoma patients. Conclusion TM and PIC levels in plasma are significantly increased in DLBCL patients. They are expected to be the indicators for effectiveness and prognosis of DLBCL patients.

Objective To study the effect of cytokine-induced killer(CIK) cells immunotherapy on immunological func-tion of patients with metastatic renal cell carcinoma.Methods A total of 70 patients with metastatic renal cell carcino-ma were randomly divided into 2 groups, 35 cases of the treatment group were added with CIK cells, while the control group was given IL-2 and IFN-α, detected the immunological function of 70 cases including the levels of CD3+, CD4+, CD8+T cells, ratio of CD4+/CD8+, one week before therapy of CIK cells and one month week after treatment. Results The levels of CD3+、CD4+cells, ratio of CD4+/CD8+in peripheral blood of patients with renal cancer of two groups were much higher than those before therapy (P<0.05), the levels CD8+ was lower after treatment, there were significant changes (P<0.05). Conclusion CIK cells immunotherapy can enhance the immunological function of patients with meta-static renal cell carcinoma.

Objective To study the clinical efficacy of anus-preserving rectectomy by using telescopic anastomosis of colon and rectal mucosa for the middle and lower rectal cancer. Methods A retrospective analysis was carried out in 402 cases with middle and lower rectal cancer undergoing telescopic anastomosis for anus-preserving procedure, including 241 males and 161 females, age ranging from 21 to 99 years, averaging at 55. 7 years. The distal margins of the tumors were within 6 - 9 cm to anal verge. According to TNM staging, there were 123 cases in Stage Ⅰ , 244 cases in Stage Ⅱ , 31 cases in Stage Ⅲ,and 4 cases in Stage Ⅳ. Results 345(345/402, 85. 8% ) cases were followed up, the median time of the follow-up was 6. 1 years. Postoperative complications included 17(4.2%) cases of stomal leakage, 11(2.7% ) cases of stomal stenosis. All patients recovered normal defecating function 12-24 weeks post operation. Local recurrence rate was 6. 3% (22/345). Hepatic and lung metastasis was 13. 6% (47/345) and 2. 6% (9/345)respectively. The five year survival rate was 68. 7% (112/163). Conclusions Anuspreserving rectectomy by using telescopic anastomosis is safe and effective procedure to treat middle and lower rectal cancer, with the preservation of anal function and without the increasing rate of local recurrence.