Objective To study the optimum process for Suanzaoren granules,and to optimize the ethanol-extracting process for jujuboside A in Semen Ziziphi Spinosae.Methods With the extracting rate of jujuboside A as the index,HPLC was used to determine the content of jujuboside A in extracted solution and the extracting conditions were optimized by orthogonal design.Results The optimum extracting condition was adding 8 times amount of 70% ethanol and refluxing for 60 min,then adding 6 times amount of 70% ethanol,refluxing and extracting for 40 min(two times).Conclusion The optimized process is stable and highly efficient.

[Objective]To explore the effects of extracorporeal shock waves(ESW) therapy on tendon-bone healing after reconstruction of the anterior cruciate ligament(ACL).[Method]Animal model of reconstruction of the anterior cruciate ligament in 18 healthy F/M New Zealand white rabbits(2～3 months old) were established using digital long extensor tendon and randomly classified into 2 groups.The ESW group was given extracorporeal shock waves therapy on 24 hours after reconstruction of the anterior cruciate ligament while the control group with only reconstruction of the anterior cruciate ligament but no more therapy.All animals were sacrificed at 2、4、8 weeks after operation for histological examinations.The specimens were stained with hematoxylin-eosin and Masson trichrome to investigate pathology change of the tendon-bone healing tissue.The ink intravascular injection was used to observe the neo-vascularization of tendon-bone healing tissue.[Result]The histological examination revealed that at 4 weeks after operation,the ESW group,tendon-bone interface was filled with proliferated fibroblasts and chondroblasts,the collagen fibers were obviously increased and regularly arranged.At 8 weeks after operation,the healing tissue at the bone-tendon interface had developed into dense connective tissue,the collagen fibers were formed in abundance and the perpendicular collagen fibers were regularly and longitudinally arranged.The transition zones of collagen fibers,fibrocartilage and bone(the structure alike a direct ligamentous insertion) occurred in the local region of tendon-bone interface.The histological observations showed that the tissue healing at tendon-bone interface of the ESW group were quicker than those of the control group.The proportion of neo-vessels at the tendon-bone interface of the ESW group were significantly higher than those of the control group at 4 and 8 weeks after operation(respectively P=0.028,P=0.008).[Conclusion]Extracorporeal shock wave treatment can significantly improve the tendon-bone early healing after reconstruction of the anterior cruciate ligament in rabbits.

Objective To study the inhibitory effect of triethyltin chloride(TETC) on proliferation of rat C6 glioma cells in vitro and its mechanism and provide basis for research on TETC in treatment for glioma.Methods MTT assay was performed to determine the inhibitory rate of 0.5,1.0 and 2.0 ?mol?L-1 TETC on rat C6 glioma cells for 24 and 48 h.The changes of nucleus of C6 glioam cells treated with 0.5,1.0 and 2.0 ?mol?L-1 TETC for 48 h were observed by fluorescent microscope.Flow cytometry was used to assess the effects of 0.5,1.0 and 2.0 ?mol?L-1 TETC on cell cycle and apoptosis in rat C6 glioma cells for 48 h.Results 0.5,1.0 and 2.0 ?mol?L-1 TETC inhibited the proliferation of C6 glioma cells in vitro,and the inhibitory rates were 7.92%,9.51%,19.03% and 15.62%,36.16%,41.92% in 24 h TETC treated group and 48 h TETC treated group,respectively.The inhibitory rate of TETC on C6 glioma cells determined by MTT assay increased in a dose-dependent and time-dependent manner,and there were significant differences of the inhibitory rates at 48 h between control and various doses groups as well as between various doses groups(P

Objective To study the inhibitory effects of triethyltin chloride(TETC) on proliferation and the morphological changes of rat C6 glioma cells in vivo.Methods C6 glioma cells were autotransplanted into 16 Wistar rats,and the rats were divided into experiment group and control group.TETC was injected into each rat through intraperitoneal route at the dose of 1 mg?kg-1?d-1 and the injection lasted 4 d in experiment group,and the physiological saline was injected into each rat in the same way as experiment group in control group.The weights of C6 glioma were measured and the proliferation rate of the tumor was calculated after 14 d.The morphological changes of C6 glioma cells were observed by HE staining and electron microscope.Results The weight of C6 glioma in TETC group was lighter than that in control group(P

Objective To evaluate the educational effectiveness of feedback debriefing in clinical training.Methods Forty medical students and fifteen teachers were enrolled in the 2015 after-internship clinical training,which was newly designed to obtain the debriefing part.The test scores and single technical practices were collected and analyzed,before and after the training.DASH scoring system was used to evaluate the effect of debriefing in the team simulation.Results were statistically analyzed by SAS 9.2(SAS institute Inc).Quantitative data were described by x ± s,while qualitative data were described by number and/or constituent ratio.Student's t test and Wilcoxon rank sum test were applied as needed.A P-value ＜ 0.05 was considered to be significant.Results The scores of the students before and after the assessment were (41.88 ± 8.54) vs.(65.06 ± 13.83),and the difference was statistically significant(P=0.000).Individual skills before and after the course had a different degree of improvement.The average DASH-scores evaluated by the students,teachers and supervisors were (39.3 ± 2.12) (very good),(35.1 ± 4.18) (good) and (37.2 ± 3.03)(very good),separately.Conclusions Potent debriefing helps to improve the effectiveness of simulationbased clinical training.

Medical imaging teaching depends on support from multimedia database which is constructed with image information provided by PACS/HIS ( Picture archiving and communication system/Hospital information system ).This paper evaluated construction,administration and application of the multimedia database,and illustrated the importance of PACS/HIS in construction of the database,as well as of the database in medical imaging teaching.

Objective To evaluate the clinical value of microvascular anastomotic devices in the reconstruction of lower extremity defects by free flap transfer.Methods A retrospective review of 42 consecutive patients who underwent lower extremity microvascular reconstruction performed from May 2013 to November 2013 by microvascular anastomotic devices was performed.Patient charts were reviewed for age,sex,etiology of defect,location of defect,flap type,anastomotic technique,complications and flap survival.Results No patients had an arterial or venous anastomosis revised.The vascular anastomosis patency rates was 100％ and the flap survival rate was 97.6％.Total complication rate (9.5％) was due to 1 partial flap loss,1 partial skin graft loss and 2 hematoma.There were no intraoperative or perioperative complications involving the use of a microvascular anastomotic device itself.Conclusion Microvascular anastomotic devices have effective vessel anastomoses in lower extremity microvascular reconstruction.Thus,it presents an ideal tool for lower extremity microsurgical reconstruction.

OBJECTIVE:To observe the efficacy and safety of edaravone combined with nimodipine in the treatment of acute large area cerebral infarction. METHODS:78 patients with acute large area cerebral infarction were randomly divided into control group (38 cases) and observation group (40 cases). Control group received aspirin platelet aggregation,reduced intracranial pres-sure,maintained water and electrolyte balance,decreased cerebral edema,Xuesetong for injection,Ginkgobiloba injection,lipid and blood pressurelowering,maintained blood sugar and other conventional treatment;observation group additionally received 30 mg Edaravone injection,adding into 100 ml 0.9% Sodium chloride injection by intravenous infusion (drip completed within 30 min),twice a day+12 mg Nimodipine injection,adding into 500 ml 0.9% Sodium chloride injection by intravenous infusion,once a day,with drip rate of 0.5-1 mg/h,for continuous 10 d,then received 40 mg Nimodipine tablet,orally,3 times a day. The treat-ment course for both groups was 15 d. Clinical efficacy,blood oxygen saturation (SpO2),hemoglobin (Hb),total hemoglobin (HbT),reduced hemoglobin(MHb)before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the incidence of adverse reac-tions was significantly lower tahn control group,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in SpO2,Hb,HbT and MHb in 2 groups (P>0.05). After treatment,the SpO2,HbT and MHb were significantly higher than before,and observation group was higher than control group,the differences were statistically signifi-cant(P<0.05);Hb was significantly lower than before,the differences were statistically significant(P<0.05),but there was no significant difference between 2 groups (P>0.05). CONCLUSIONS:Based on the conventional treatment,edaravone combined with nimodipine shows significant efficacy in the treatment of acute large area cerebral infarction,it can effectively recovery neuro-logical function damage and protect the brain tissue,which can reduce the incidence of adverse.

Objective To evaluate the value of intermittent splenic artery occlusion in the treatment of iatrogenic splenic injury and the cause of ischemia reperfusion injury.Methods Experimental animals using dogs were divided into experimental group and control group according to whether the splenic artery was blocked.The animal model of iatrogenic splenic injury was established by general anesthesia.Experimental group was treated with intermittent splenic artery blockage combined with gelatin sponge oppression of the wound to stop bleeding.The first time of splenic artery occlusion was 15 min and continued for 10 min and for another 5 rmin if still bleeding.Then hemostatic effect after removing blocking and oppression was observed.Control group was only treated with gelatin sponge compression to stop bleeding.Blood samples and tissue samples were collected before blocking and after reperfusion for 2 hours in experimental group,and before compression and relieving the compression for 2 hours in control group.IL-1 (interleukin),SOD (superoxide disproportionation enzyme),MPO (myeloperoxidase),MDA (malondialdehyde) and caspase-3 (aspartame acid cysteine protease) were detected.Results The control group still had bleeding,while the experimental group had successfully stopped bleeding.Serum markers before and after occlusion in the experinental group were IL-1 (124.4 ± 106.8 vs.121.2 ± 105.1),SOD (4.7 ± 2.7 vs.5.2 ± 1.8) and MDA (8.8 ±6.5 vs10.8 ±7.5).There were no significant differences on serum markers in two groups after occlusion/oppression including IL-1 (121.2 ± 105.1 vs.162.8 ± 73.8),SOD (5.2 ± 1.8 vs.4.7 ± 2.8) and MDA (10.8 ±7.5 vs.9.6 ±6.6) (P＞0.05).Histological indicators before and after occlusion in the experimental group included MPO (0.62 ±0.23 vs.0.68 ±0.21) and Caspase-3 (0.90 ±0.29 vs.0.86 ± 0.26),and there was no statistical difference on MPO (0.68 ±0.21 vs.0.86 ±0.23 after two sets of experiments) and Caspase-3 level (0.86 ± 0.26 vs.1.21 ± 0.18) (P ＞ 0.05) in two groups after occlusion/ oppression.Conclusion The therapeutic effect of intermittent splenic artery occlusion combined with gelatin sponge compression hemostasis is safe and effective and without obvious ischemia reperfusion injury.

Objective:To investigate the effect of early enteral nutrition combined with Bacillus in the treatment of patients with digestive tract perforation.Methods:59 patients with emergency digestive tract perforation were randomly divided into experimental group (EN plus Bacillus,n =31) and control group (TPN,n =28).The patients in the experimental group were given enteral nutrition plus Bacillus after first days (＜ 24 h),and the control group was treated with parenteral nutrition support on the first day after surgery.The average hospitalization time,length of ICU stay,incidence of complications,and serum C-reactive protein in the two groups were analyzed.Results:The average length of hospitalization time,ICU stay,recovery of bowel function and eating time were significantly shorter in the experimental group than in the control group(P ＜ 0.05).There was no significant difference in nutrition index between the two groups during the perioperative period (P ＞ 0.05).The C-reactive protein in the experimental group was significantly lower than that in the control group fourth days after operation (P ＜ 0.05).The incidence of postoperative wound infection in the experimental group was significantly lower than that of the control group (P ＜ 0.05).There was no significant difference in the incidence of other complications.Conclusion:Early administration of enteral nutrition combined with Bacillus can significantly shorten the intestinal function recovery time,decreasethe average hospitalization days,reduce the postoperative wound infection rate and thus improve the outcome of patients with digestive tract perforation.