A method of LC-QTOF/MS combining with chemical synthesis has been used to determine the structures of three novel bile acids from bear bile powder. Reference substances of tauroursodeoxycholic acid and taurochenodeoxycholic acid were oxidized by pyridinium chlorochromate. The products were analyzed by LC-QTOF/MS. Total 4 products including 3 isomers were predicted and identified according to the PCC oxidation theory and LC-QTOF/MS results. Bear bile powder samples were dissolved by methanol and analyzed by LC-QTOF/MS. Three unknown peaks were found and identified as 2-[[(3beta, 5beta)-3-hydroxy-7, 24-dioxocholan-24-yl]amino]-ethanesulfonic acid, 2-[[(5beta)-3, 7, 24-trioxocholan-24-yl]amino]-ethanesulfonic acid and 2-[[(5beta, 7beta)-7-hydroxy-3, 24-dioxocholan-24-yl]amino]-ethanesulfonic acid, separately, by matching their results with that of oxidation products above.

Objective To compare the short-term efficacy of AC TightRope plate and clavicular hook plate in the treatment of acromioclavicular joint dislocation.Methods A retrospective case control study was conducted to analyze the clinical data of 32 patients with acromioclavicular joint dislocation admitted to Yifu Hospital Affiliated to Nanjing Medical University from April 2016 to December 2017.There were 23 males and 9 females,aged 26-61 years [(43.5 ±9.5)years].According to Rockwood classification,there were 23 patients with type Ⅲ and 9 patients with type Ⅴ.The patients were divided into AC TightRope group and clavicular hook plate group according to different treatment methods.There were 17 patients in AC TightRope group,including 12 males and 5 females,aged (42.6 ± 10.3)years.There were 15 patients in clavicular hook plate group,including 11 males and 4 females,aged (44.5 ± 8.9)years.The incision length,operation time,intraoperative blood loss,hospitalization time,postoperative visual analogue scale (VAS) of the affected shoulder,functional recovery of shoulder joint and complications were compared between the two groups.Results All patients were followed up for 6-26 months,with an average of 15 months.There was no significant difference between the two groups in hospitalization time (P ＞ 0.05).In the AC TightRope group and clavicular hook plate group,the operation time was (41.5 ±4.2)minutes and (60.1 ± 4.2) minutes,respectively (P ＜ 0.01);the incision length was (3.6 ± 0.3) cm and (10.1 ± 0.6) cm,respectively (P ＜ 0.01);the intraoperative blood loss was (45.3 ± 11.1) ml and (78.3 ± 16.0) ml,respectively (P ＜ 0.01);the postoperative VAS of the shoulder was (1.9 ± 0.5) points and (3.1 ± 0.7) points,respectively (P ＜ 0.05);the excellent and good rate of postoperative recovery of shoulder joint function was 100％ (17/17) and 67％ (10/15),respectively (P ＜0.01).There were no complications such as surgical incision infection,intraoperative neurovascular injury or condylar fracture during the perioperative period.No serious postoperative complications such as internal fixation loosening,loss of reduction or recurrence of dislocation were found in both groups.Conclusion For acromioclavicular joint dislocation,AC TightRope can obtain good clinical effect and has obvious advantages in operation time,incision length and blood loss,with lower incidence of shoulder pain and better functional recovery compared with clavicular hook plate.

Objective To evaluate the clinical efficacy of a combination of Ilizarov technique, bone grafting and ankle traction for treatment of nonunion of the distal tibia within 2 cm around the ankle joint. Methods A retrospective study was performed on the patients who had been treated at Department of Orthopaedics, Sir Run Run Shaw Hospital from September 2014 to January 2018 for nonunion of the distal tibia within 2 cm around the ankle joint. They were 8 men and 4 women, aged from 32 to 56 years ( average, 41 years). Their injury was all unilateral, involving 5 left and 7 right ankles. They had all received internal fixation at other hospitals for 6 to 18 months. After we treated them simultaneously with Ilizarov technique, bone grafting and ankle traction, they could walk with crutches as soon as 3 days after surgery in some cases. Their affected limbs were then subjected to gradual weight-bearing walking until they could walk normally without any aid 3 to 6 months after surgery. Their postoperative ankle functions were evaluated according to the ankle-hindfoot scores of the American Orthopedic Foot and Ankle Society ( AOFAS) system. Results The 12 patients were effec-tively followed up for 12 to 24 months ( average, 19 months). All their incisions healed well with no incision or pin-tract infection. All their bone nonunions healed after circular external fixation for 12 to 36 weeks. Their AOFAS scores ranged from 75 to 96 points, showing good functional recovery of the ankle joint. Conclusion A combination of Ilizarov technique, bone grafting and ankle traction is an effective treatment for nonunion of the distal tibia within 2 cm around the ankle joint, leading to preservation of the ankle function and prevention of posttraumatic ankle osteoarthritis.

Objective To assess the prognosis and effect on renal function of pediatric urolithiasis caused by melamine-contaminated milk powder (PUMMP) in a long-term follow-up.Methods One hundred and two of 8335 children (≤ 6-year-old) with history of consuming melamine-contaminated milk powder screened in our hospital were followed up for eighteen months after diagnosis. Urinary system ultrasonography, urinalysis, urinary microprotein profiles [microalbumin (ALBU), immunoglobulin G (IgG), and N-acetyl-β-D-glucosidase (NAG)], urinary melamine and cyanuric acid were examined in the first visit and at the end of follow-up. Results Follow-up was completed in 91 children and the stone was excreted in 82 children (90.1%).Stones less than 5 mm in diameter were most vulnerable to discharge, and stones larger than 10 mm could not be expelled without interventions. At the end of follow-up, no melamine or cyanuric acid was found in the urine samples of 74 patients. Urinalysis showed that incidences of proteinuria, microscopic hematuria and leukocyturia were 0%, 5.1% and 2.0%, which were significant different from those in the first visit (Pproteinutria=0.123, Phemnatuna=0.038 and Pleukocyhuris=0.005).Urinary microprotein profiles revealed that some children whose urinalysis was normal still presented glomerular and renal tubular injury and the abnormal rates were 8.8% and 12.1%respectively. The glomerular injury was mainly related to persistent stone, male and younger.Conclusions 90.1% of children with PUMMP passes urinary stones at the end of follow-up.Stone size is the major risk factor of discharge. No melamine or cyanuric acid is found in the urine of children. After eighteen months, glomerular and renal tubular injury is still found in some patients. Further follow-up is necessary.