OBJECTIVE To introduce and discuss the quality management system of medical loaner instrumentation and implantables in the US.METHODS With US national standards and industry guidelines on loaner instrumentation and implantables,and the practical problems we encountered in China on this subject,we will discuss their quality management.RESULTS We should apply whole process quality management to loaner instrumentation and implantables.CONCLUSIONS Zero tolerance quality management in loaner instrumentation and implantables is crucial for medical safety.

Aim To study the chemical constituents of the underground part of Ligularia pleurocaulis (Franch.) Hand-Mazz.. Methods The dried roots and rhizomes of L.pleurocaulis were extracted with methanol. Isolation and purification were performed by silica gel column chromatography and recrystallization etc. Structures of the pure compounds were established on basis of spectral analysis. Results Twelve compounds were obtained from L.pleurocaulis, they were 6-angeloyloxy-furanoligu-larenone (1), 2-oxo-3-hydroxy-eremophila-1(10),3,7(11),8-tetraen-8,12-olide (2), tiglic acid (3), oleanolic acid (4), lupeol (5), β-sitosterol (6), daucosterol (7), caffeic acid (8), emodin (9), 7-methoxy-coumarin (10), ferulic acid (11) and 4-hydroxy-2,5-dimethoxy-benzaldehyde (12). Conclusion Compound 1 is a new eremophilane and compound 2 is a new natural compound. All above compounds were obtained for the first time from L.pleurocaulis.

Objective To explore the causes of bile duct injury during laparoscopic cholecystectomy and its treatment.Methods From January 1998 to February 2007,totally 8600 cases of LC were performed in our hospital.Bile duct injury occurred in 36 of them,among which,the common hepatic duct was cut in 20 cases,the common bile duct was severed in 4 patients,the common hepatic duct was cut and freed in 4;incomplete clipping of the common hepatic duct or common bile duct occurred in 3 and 1 cases respectively;3 cases had injury to the conjunction of the cystic duct and common hepatic duct;electrical burn injury happened in 1 patient.Thirty one of the injured cases were detected during the laparoscopic surgery,while the other five were found because of jaundice or biliary leakage.The patients received bile duct repair and T tube drainage(24),T tube drainage(4),Roux-en-Y bowel biliary anastomosis(4),bile duct anastomosis(1),or removal of the titanium clips after the accidents.Results One of the patients who received bile duct anastomosis developed biliary stenosis after the T tube was withdrawn in 2 months after the surgery,Roux-en-Y bowel biliary anastomosis was thus performed 3 months later.Two patients who underwent Roux-en-Y anastomosis developed anastomotic stenosis after the operation,and thus received a second anastomosis in 11 months.These 3 patients who received totally 3 operations,were followed up for 2 to 3 years,none of them developed cholangitis or biliary stones.One patient in this series had refractory cholangitis,jaundice,and liver function impairment,and was cured after 1-year anti-inflammation and liver support therapy.In the other 32 patients,an 8-to 36-month follow-up(mean,16 months) was achieved,during which none of them showed any complications.Conclusions Bile duct injury can be due to lacking experience and knowledge of the complications of laparoscopic cholecystectomy,inappropriate enrollment of the patients,inaccurate operation,misuse of the surgical instruments,or being unable to discern the Calot's triangle.Strict indications for the operation,advanced training for young doctors,and appropriate timing for conversion to an open surgery are necessary to decrease the rate of bile duct injury.

One new quinoline alkaloid and seven known bisabolane sesquiterpenes: 2-(2'-methyl-1'-propenyl)-4, 6-dimethyl-7-hydroxyquinoline(1), 2, 5-dihydroxybisabola-3, 10-diene(2), 4, 5-dihydroxybisabola-2, 10-diene(3), turmeronol A(4), bisacurone(5), bisacurone A(6), bisacurone B(7), bisacurone C(8), as well as dehydrozingerone(9) and zingerone(10) were isolated from the root tuber of Curcuma longa. Their structures were identified by spectral evidence. Compound 1 is a new compound, compounds 6-8 were isolated from this plant for the first time and compounds 9-10 from Curcuma for the first time.

Object To perform detail studies on different species of Ligusticum L (Uumbelliferae) currently prescribing in Yunnan Province for the purpose to clarify the claotic state of its clinical use Methods By literature retrieval, field and market center inspection and pharmacognostic identification in comparison with those documented in classical literatures to arrive at a reasonable evaluation Results Two varieties of Ligusticum L., the Huanggaoben and Heigaoben were currently in common use in Yunnan Province Huanggaoben, the yellow ligusticum, was originated from Sinodielsia yunnanensis Wolff and Ligusticum delavayi Franch Heigaoben, the balck ligusticum, was oringinated from Ligusticum pteridophyllum Franch Conclusion The study may provide references for the further study and clinical use of this medicinal plant

Object To explore the method for high quality DNA extract from plant Chinese medicinal materials containing developed xylem Methods The process of DNA includes wash with Tris buffer, extract with CYAB buffer and purification mainly Results Using this method, the total DNA was isolated from Cimicifugae foelida L., Arlia chinensis L., Paeoniae lactiflora Pall.,Aucklandia lappa Decne.,Lindera aggregata (Slms) Kostern., and Akebia quinata Decne. etc This method is preferable in removing pigments, polysaccharides, substance disturbing PCR Conclusion In this process, common reagents are used, lower cost is of advantage to popularize This study provids the applying foundations for the DNA identification of plant Chinese medicinal materials

Senecio cannabifolius var integrilifolius (Compositae), locally known as "Fanhuncao" in China, is a folk herb used for the treatment of pneumonia, virus influenza and bronchitis. To investigate the chemical constituents of this herb, water extract of the aerial parts was subjected to various chromatography on normal/reversed phase silica gel and Sephadex LH-20 column. Eleven compounds were obtained and identified on the basis of their physicochemical properties and spectroscopic analysis as senecine (1), p-hydroxy-benzeneacetic acid (2), protocatechuic acid (3), 2,5-dihydroxy-benzeneacetic acid (4), 3,4-dihydroxy-benzeneacetic acid (5), vanillic acid (6), caffic acid (7), succinic acid (8), 2-furoic acid (9), 1,2,4,5-tetrahydro-jacaranone (10), and 4-(pyrrolidin-2-one)-phenylacetic acid (11). Compound 1 was structurally identified to be a new compound;the other compounds were isolated from this plant for the first time.

The medicinal herbs derived from genus Senecio have been commonly used in Chinese medicine and triggered attention in recent decades for that they contain the hepatotoxic pyrrolizidine alkaloids. Therefore the botanical pharmacognostic study to authenticate those herbs based on their macroscopic and microscopic characteristics is important for the assurance of safety when they are applied as raw material for extracts or for finished products. In this paper, 13 taxa (11 species and 2 varieties) of Senecio plants were collected and their macroscopic and microscopic characteristics were observed and described by digital microscopic illustration. The results showed that the distribution of collenchyma in the cortex, the level of development for pericycle, the location of the phloem, and the ratio of pith in transverse sections of the stems, and the morphology of the leaf epidermal cells, the stomatal types and the non-glandular hairs in leaf surface view were found to be the main microscopic characteristics for authentication of different Senecio species. The herbs derived from genus Senecio can be distinguished from each other on the basis of their macroscopic and microscopic characteristics, and those observation can be used for the identification of commercial crude drugs from Senecio plants.

Danshen (Salvia miltiorrhiza Bunge) hairy roots were obtained by infecting Danshen leaves with Agrobacterium rhizogenes 9402. Besides rosmarinic acid (RA) and salvianolic acid B (SAB), the hairy root could also produce salvianolic acid K (SAK), salvianolic acid L, ethyl salvianolic acid B (ESAB), methyl salvianolic acid B (MSAB), and a compound with a molecular weight of 538 (compound 538) identified by using LC-MS. Effects of methyl jasmonate (MeJA) and yeast elicitor (YE) on the accumulation of these compounds had been investigated. MeJA increased the accumulation of SAB, RA, SAK, and compound 538 from 4.21%, 2.48%, 0.29%, and 0.01% of dry weight to 7.11%, 3.38%, 0.68%, and 0.04%, respectively. YE stimulated the biosynthesis of RA from 2.83% to 5.71%, but depressed the synthesis of SAB, SAK and compound 538. It was indicated in all the results that these Danshen hairy roots could be used as alternative resources to produce salvianolic acids. Analysis of the content variation of these compounds after elicitation suggested that SAK and compound 538 might be the intermediates in the biosynthesis from RA to SAB in Danshen hairy roots.