This article was aimed to study the pharmacokinetics of mussaenoside in rats. Gardenoside was used as the internal standard in the content determination of mussaenoside in rat plasma with HPLC. The chromatographic conditions were Diamonsil C18 (2) column (150 mm í 4.6 mm, 5 μm), mobile phase of methanol:0.5% glacial acetic acid (30:70), flow amount of 1.0 ml/min, detection wavelength at 238 nm, column temperature at 30℃. Compartment model fitting of average plasma concentration in rats - time data had been conducted after mussaenoside was given to mice through single intravenous injection with the help of DAS 2.0 pharmacokinetics intelligence analysis software. The results showed that the plasma concentration using 2-comparment model intravenous injection calculation method, which corresponded well to that of actually measured (weighting of 1), was proved superior to other models. The distribution half-life time (t1/2α) was 9.892 min and the elimination half-life time (t1/2β) was 55.384 min. It was concluded that the established method was convenient, accurate and stable, which can be used for the study on phar-macokinetics of mussaenoside. Mussaenoside was distributed rapidly in the body of rats. The main process of mus-saenoside in the body of rats was elimination. The metabolic rate was at moderate speed.

Objective To evaluate retroperitoneal laparoscopic surgery in the treatment of primary aldosteronism. Methods Retroperitoneal laparoscopic surgery was performed in 90 patients with primary aldosteronism (92 sites on either or both sides).Their clinical indicators were compared with those of 30 cases undergoing open surgery. Results Retroperitoneal laparoscopic procedures were successfully performed in 91 of the 92 sides.In these successful cases,mean operative time was 93 minutes (compared with 114 minutes in open surgery cases),mean volume of blood loss was 36 ml (compare with 87 ml),mean postoperative hospital stay was 6.8 d(compared with 11.0 d),mean time to flatus was 1.6 d (compared with 3.1 d),and mean time to walk around was 2.1 d(compared with 3.3 d), P

Objective To explore the role of intracranial electrode EEG monitoring for localizing epileptogenic zone in epilepsy.Methods 20 patients with refractory temporal lobe epilepsy,whose seizure onsets were unable to be localized by MRI、routine EEG and clinical characteristic,accepted long-term intracranial electrode EEG monitoring.Bitemporal lobe subdural implanted trip electrode were used to perform the ictal and interictal EEG monitoring under the guiding of the stereotactic technique.The results routine of EEG,MRI and intracranial electrode EEG were combined.The accuracy for localization of epilepitogenic zone was evaluated based on the followed-up.Results The intracranial electrode EEG monitoring was implanted within 1～5 d.Each patient was recorded the ictal and interictal discharge and was detected clinical onsets at least twice.All patients could be localized by ictal EEG.The consistency between interical EEG and ictal EEG were observated in 15 cases,the inconsistency in 3 cases,and 2 cases were bilateral discharge in interictal.The clinical outcome showed that patients were seizure-free in 13 cases(65%),improved significantly in 3 cases(15%),improved in 3 cases(15%),unimproved in 1 case(5%)according to Engel's criteria after surgery.No significant complication was found in all patients.Conclusion The intracranial electrode EEG monitoring can localize epileptogenic zone and offer reliable evidence for epilepsy surgery.

Objective To evaluate clinical significance of laparoscopic adrenalectomy for treatment of primary aldosteronism.Methods From Jan.1999 to Dec.2009,227 patients(92 males and 135 females)with a confirmed diagnosis of primary aldosteronism underwent laparoscopic adrenalectomy.The median age was 42years old,ranging from 22 to 69 years old.The median disease duration was 4.6 yeas,ranging from 2 months to 15 years.5 cases underwent peritoneal laparoscopic adrenalectomy and 222 cases underwent retropefitoneal laparoscopic adrenalectomy.All cases had hypokalemia,hpertension,high plasma aldosterone and low plasma rennin preoperatively.Of all the cases,there were 205 cases with aldosterone-producing adenomas among whom 80 cases underwent total adrenalectomy and 125 cases underwent partial adrenalectomy.There were 22 cases with unilateral adrenal hyperplasia and all of them underwent total unilateral adrenalectomy.Results Procedures were successfully performed in all the 227 cases.The operation duration ranged from 15 to 156 min(39 min as the median)and the blood loss ranged from 5 to 220 ml(20 ml as the median).The hospitalization time ranged from 5 to 9 days (6.9±1.2 days as the median).All the cases were followed up from 6 months to 2 years(1.2 years as the median).Postoperative potassium level resumed normal in all cases.Blood pressure resumed normal in 180 cases(80%).No adrenocortieal insufficiency and any other complication occurred.Conclusion Retropreitoneal laparoscopic partial or total adrenalectomy for treatment of primary aldosteronism is a safe and feasible procedure.

Objective To summarize clinical characteristics of ectopie pheochromocytoma in order to improve the diagnosis and treatment of this disease.Methods Clinical data of 36 cases of pathologically proved ectopic pheochromocytoma treated in Tianjin Medical University General Hospital from 1990 to 2010 were retrospectively analyzed.Hypertension was observed in 28 cases.5 cases had hypertension at the end of urination. 1 case was proved to have ectopic pheochromocytoma by physical examination.Abdominal pain occulted in 2 patients.Urinary VMA was measured in all the 36 cases,and 32 esges had an elevation of VMA(88.9%).The lesions were localized mainly by abdominal ultrosonggraphy,CT,MRI and 131 I-MIBG.All cages underwent operation,including 4 laparoscopic surgery.Results Of the 36 patients with ectopic pheochromocytoma,34 cases had sinsle tumor,and 2 cases had multiple tumors.The diameter of the lesions was from 3.4 cm to 18.2 cm in size.Postoperative pathological examination showed 27 cases of ectopic pheochromocytoma were benign and 9 cases were malignant.Conclusions VMA level is an important marker to detect ectopic pheochromocytoma.Tumor localization is difficult.131 I-MIBG is of great value for localization of the lesion.Meticulous preoperative preparation is extremely important.Surgical resection of the tumor is the best therapy.Laparoscopic surgery can be the new choice for treatment of ectopic pheochromocytoma.Patients with malignant ectopic pheochromocytoma may be treated with 131 I-MIBG after surgery.

Objective To review clinical characteristics and treatment of multiple endocrine neoplasia type 2A (MEN-2A).Methods The clinical data of 13 patients with MEN-2A admitted to our hospital between 1988 and 2011 were retrospectively reviewed.All 13 cases were diagnosed as pheochromocytoma with medullary thyroid carcinoma,presenting no hyperparathyroidism,including 8 cases who had medullary thyroid carcinoma before pheochromocytoma and 5 cases who had medullary thyroid carcinoma and pheochromocytoma simultaneously.All 13 cases underwent resection for pheochromocytoma; 9 cases had bilateral adrenal resection,including 4 cases undergoing laparoscopic resection for pheochromocytoma.Thyroidectomy with bilateral dissection of regional lymph nodes was performed in 10 patients,and nodule enucleation was performed in 3 remaining patients.Results Adrenal pathology reported pheochromocytoma in all cases,including 3 malignant cases.Thyroid pathology reported medullary thyroid carcinoma in all cases.All 13 patients were followed-up visit,10 cases survived and 3 died from distant metastasis of medullary thyroid carcinoma.Conclusions MEN-2A is a rare disease.Surgery is the only treatment for this disease ; when patients have both pheochromocytoma and medullary thyroid carcinoma,to first remove the pheochromocytoma is preferable.

Objective To evaluate retroperitoneal laparoscopic adrenalectomy. Methods From June of 1999 to January of 2001, retroperitoneal laparoscopic adrenalectomy was performed on 52 patients with adrenal diseases, including 34 cases of aldosterone-preducing adenoma,3 nodular hyperplasia bilateral in 1, 5 Cushing's syndrom,1 Cushing's disease, 3 adrenal pheochromacytoma (bila- teral in 1), 4 nonfunctional adrenal adenoma, 1 myelolipoma and 1 metastasis carcinoma. Results 54 sessions of retroperitoneal adrenalectomy have been carried out for 52 patients (2 on both sides) with success in 51 procedures. The procedure was converted to open operation in 3 occasions because of bleeding or adhesion. The mean operation time was 135 minutes (40～270 min), and the estimated blood loss 45 ml (5～150 ml) with no need of transfusion. The postoperative hospital stay was 6 d (3～14 d) and the mean analgesia consumed 8.5 mg (0～50 mg) of morphine equivalents with no need of any analgesic at all in 17 patients. Conclusions Retroperitoneal laparoscopic adrenalectomy was less traumatic to the patients, with less postoperative discomfort and quicker recovery. The procedure should be considered as the first choice of therapy for benign adrenal diseases.

[Objective]To discuss the surgical technique and clinical effects of open reduction and internal fixation with T style plate in the treatment of Die-punch fracture of distal radius.[Method]From August 2003 to October 2007,twenty-nine patients diagnosed as Die-punch fracture according to X-ray and computerized tomography were treated with open reduction through volar approach and internal fixation with T style plate and bone-grafts to support the articular surface of impacted fractures.There were 20 males and 9 females,with an average of 40.5 years(range 19-62 years).The fractures were caused by falling(n=23),traffic(n=4) and by athletics(n=2).There were 6 cases of open fracture.Eighteen cases were in the right wrist,and 11 in the left wrist.The displacement of articulatzons was from 1.5 to 3.5 mm.[Result]Twenty-six patients were followedup for 9 to 45 months,with an average of 28 months.Posteroanterior and lateral radiographs were taken periodically and fracture healing occurred all within 12 weeks.According to ADL standard and radiographs,21 cases were excellent(ADL scores:38-40),3 cases were good(scores:35-37).The excellent to good rate was 92.3%.No infection occurred.[Conclusion]Open reduction and internal fixation can help restore the smoothness of the articular surface and reduce the incidence of traumatic osteoarthritis.It is effective against the Die-punch fractures of distal radius.

0.05).In the 16 cases,17 retroperitoneal laparoscopic excisions of pheochromocytoma were successful,only 1 was converted to open surgery due to intraoperative bleeding. The mean operative time was 85?31 (range,45 to 150) min in laparoscopic surgery group vs 155?39 (90 to 240) in open surgery group (P

Objective To evaluate the feasibility of transperitoneal laparoscopic adrenalectomy for 3 patients with primary aldosteronism who previously underwent ipsilateral adrenal surgery or nephrectomy. Methods From October 2003 to March 2004,transperitoneal laparoscopic adrenalectomy was performed on 3 male patients with primary aldosteronism,including 2 patients (39 and 72 years,respectively) who had previously undergone ipsilateral retroperitoneal laparoscopic partial adrenalectomy for Conn’s adenoma and 1 patient (42 years) who had previously undergone ipsilateral open nephrectomy for renal tuberculosis. Results Transperitoneal laparoscopic adrenalectomy was successfully performed on all the 3 patients; no complication occurred.The mean tumor size was average 1.7 cm in greatest dimension;the mean operative time was average 93 min;the mean estimated blood loss was average 18 ml,and no one needed blood transfusion.The postoperative food intake time was average 17 h,and postoperative hospital stay was average 5.0 d. Conclusions Although scar and adhesion of previous operation may present more difficulties in the subsequent operation,it is feasible to perform transperitoneal laparoscopic adrenalectomy through different surgical access on the patients who have previously underwent ipsilateral retroperitoneal adrenal or nephric surgery.