Objective To explore the significance of computed tomography in preoperative classification and surgical planning for Pilon fractures. Methods A retrospective analysis was done for 52 cases of Pilon fracture who had been admitted to our hospital from January 2000 to June 2005 and whose X-ray, Axial CT scan and follow-up data were complete. In the preoperative evaluation, the fractures were classified, the fracture angles measured and the anatomy of fragments analyzed on the basis of their plain radiographs and CT scans. The operative methods and approaches were based on the specific fracture types, fracture angles and courses of fracture line on the CT scans. Five patients received manipulative reduction and plaster splint, five closed reduction and internal fixation with lag screws coupled with plaster splint, 17 closed reduction and internal fixation with minimally invasive percutaneous plate osteosynthesis (MIPPO), 16 closed reduction and external fixation combined with limited internal fixation; and nine open reduction and internal fixation (ORIF). Results The average follow-up was 17.2 months.CT scan revealed an increased number of fragments in 21 patients. The fracture types were changed in nine patients according to new CT discoveries which revealed coronal main fracture lines in 61.5% of the cases and sagittal in 34.6% . The approaches and internal fixation positions varied according to the two different kinds of fracture. According to Mazur’ s criteria, the postoperative surgical results were evaluated as excellent in 30 cases, good in 13, fair in eight and poor in one. On average, the good to excellent rate was 82.7% for all the patients, 57.1% for patients with type Ⅲ fractures, but only 44.4% for patients with die-punch fragments in CT scan. Conclusions CT scan can increase accuracy in classification of Pilon fractures. Open reduction of articular surface is preferred for type Ⅲ fractures. Operative approaches and positions of the internal fixation should be based on the anatomy of main fracture lines and fragments. Die-punch fragments should be reduced under direct visualization and indicate unfavorable prognosis.

[Objective] To establish the contents determining means of baicalin in Jinchaihuang granules.[Methods] Baicalin was carried out by HPLC.[Results] Baicalin showed a good linear relatiaoship at a range of 0.157~1.256?g,r=0.9997.The average recovery was 101.31%,and RSD was 1.26%.[Conclusion]The methods are accurate and quick,and can be used for the quality control of Gujingdan granules.

Objective To evaluate accuracy of preoperative tumor grade and intracperative gross examination of myometrial invasion in patients with clinical stage Ⅰ endometriod adenocarcinoma for lymphadenectomy. Methods Clinic-pathological data were retrospectively collected from 687 patients with clinical stage Ⅰ endometriod adenocarcinoma who underwent operation in Women's Hospital, Zhejiang University School of Medicine from January 1999 to December 2008. According to postoperative histology diagnosis, accuracy of preoperative tumor grade by curettage and depth of myometrial invasion by intraoperative gross examination was evaluated, and clinic-pathological factors associated with accuracy were analyzed. Results Sensitivity, specificity, accuracy, false negative rate, false positive rate, and positive and negative predictive value for the prediction of needing for intraoperative lymphadenectomy in patients with clinical stage Ⅰ endometriod adenocarcinoma were 70. 4% ,80. 2% ,77.6% ,12.0%, 43.0%, 57.0% and 88.0%, respectively. Analysis of mutil-factors shown that patient age, tumor size, lymph node metastasis and extrauterine spread lesions were independent factors affected the accuracy of prediction(P ＜ 0. 05 ). Conclusion Prediction of needing for lymphadenectomy by preoperative tumor grade and intraoperative gross examination of myometrial invasion is reliable in clinical stage Ⅰ endometriod adenocarcinoma patients, while there is a highly false negative rate in prediction of not needing for lymphadenectomy, while other prognostic factors such as patient age, tumor size, lymph node metastasis and extrauterine spread lesion should be together considered.

Objective To establish a RP-HPLC method for the determination of encapsulation efficiency (EE) and medicine loading (ML) in β-elemene-loaded Nano Polymeric Micelles; To study its release characteristic in vitro. Methods DSPE-PEG2000 was used as carrier to prepare medicine-loaded micelles. EE and ML were determined by petroleum ether extraction method, and its release characteristic in vitro was studied by dialysis method. Results The average EE and ML ofβ-elemene-loaded Nano Polymeric Micelles were 89.47%and 8.33%, respectively. Its release characteristic was slow. Conclusion The method for EE and ML determination is simple and accurate, and the prepared micelles have the property of sustained release.

Objective To investigate the relationship between heat shock protein 72 (HSP72) and liver fibrosis in pediatric patients with biliary atresia and the significance of its expression.Methods The clinical and pathological data of 30 patients with biliary atresia were selected from June 2013 to June 2015,and the expression of HSP72 in liver tissues was determined by streptomycin peroxide (SP) immunohistochemical method.Results The greater group of liver fibrosis degree with biliary atresia was less than the lighter group in the expression of HSP72 (Z =-4.16,P ＜ 0.01).There was negative correlation between HSP72 expression intensity and operation age (r =-0.704,P ＜ 0.01).Meanwhile,there was negative correlation between HSP72 expression intensity and postoperative cholangitis (r =-0.371,P ＜ 0.05).When the expression of HSP72 was higher,the autologous liver survival rate was higher (x2 =9.482,P ＜ 0.01).Conclusions The expression of HSP72 in liver tissues of patients with biliary atresia is closely related to the degree of liver tissue fibrosis.HSP72 expression may be one of the factors affecting the prognosis of patients with biliary atresia,and can be used as a reference index for evaluating prognosis.

Objective To establish QAMS method to determine the contents of three alkaloids in bile processed Coptidis Rhizoma; To compare the results of QAMS with those from external standard method; To prove the feasibility of QAMS.Methods An HPLC method was developed. Berberine hydrochloride was selected as the internal reference substance. 2 relative correction factors (RCF) of berberine hydrochloride to palmatine hydrochloride and to jatrorrhizine hydrochloride were established. Obtained RCFs were used to conduct content calculation (calculated value) to complete QAMS method. At the same time, the contents (measured value) of the three components were also determined by external standard method. Calculated value and measured value were compared.Results The analysis results showed that there was no significant difference between the calculated values and the measured values of the three alkaloids in 10 batches of bile processed Coptidis Rhizoma.Conclusion The QAMS method can be applied in the determination of alkaloids in bile processed Coptidis Rhizoma.

This study was designed to validate the correlation between integrated pharmacokinetic and therapeutic effects of alkaloids using bile processed Rhizoma Coptidis (BRC). Rats were divided into three groups: normal, disease model, model+BRC. Rats were induced to have an excessive heat syndrome. Rectal temperatures were collected at 0, 3, 6 and 9 h after single oral administration of the drugs. The plasma concentrations of three alkaloids were quantified at different times by UPLC-MS/MS after the administration of BRC. An approach of self-defined weighting coefficiency was created to the holistic pharmacokinetic profiles of alkaloids in BRC. The classified and integrated synthetic concentrations were obtained, and then the pharmacokinetic parameters of alkaloids were calculated from non-compartmental model analysis. The potential relationship between the integrated mean concentration of alkaloids and the antifebrile efficacy was investigated. The holistic t(max) of alkaloids was 1.11 h, the antifebrile effect of BRC at 3 h was improved over the model group. Double peaking appeared in the integrated blood concentration-time curve, the second t(max) of alkaloids was 4.82 h. The antifebrile effects of BRC at 3-6 h were significant, and the antifebrile effects at 6-9 h was decreased significantly. Dynamic variation of alkaloids of BRC in the body exhibited the similarity to the pattern of its antifebrile effect.

Objective To investigate the impact of leukocyte-removed priming fluid on lung function peri-CPB in infants. Methods Selected 60 infants of less than 1-year-old, with ventricular septal defect (VSD), were randomly assigned to the experimental group and the control group, the experimental group took blood leukocyte-removed priming fluid, and the control group took banked blood-derived priming fluid. Indicators of OI, PaO2/PAO2, A-aDO2 and RI were recorded at the corresponding period of cardiopulmonary bypass (pre-CPB, 2h, 6h, 12h, 24h and 48h post-CPB). Results At 2h, 6h,12h post-CPB, OI and PaO2/PAO2 of the experimental group were higher than those of the control group (P

In order to set up sustainable fundraising mechanisms for community health services, it is necessary to calculate the sum of compensation needed for basic public health services and formulate compensation policies on the basis of defining items of basic public health services and in accordance with the economic levels of various regions. At the same time, it is necessary to enforce government purchases after working out strict assessment criteria so as to ensure that funds for community health services are genuinely devoted to basic public health services.

Objective To establish a rapid assay for the determination of methotrexate (MTX) in serum.Method The assay was based on the ultraviolet absorbance of methotrexate at 306 nm. The separation of the drug was done by high performance capillary electrophoresis (HPCE). The bare fused-silica capillary was 60 cm in total length, 50.5 cm in efficient length and 75?m in diameter. The voltage of 25 kV was applied. The running buffer was 75 mmol/L phosphate, pH7.4. The performance of methodology was evaluated.Result The complete separation of MTX was achieved within 10 min. The linearity of the assay was from 1.1 ?mol/L to 1100.0 ?mol/L. The minimal detection limit was 0.55 ?mol/L.The recovery of MTX was from 88.2% to 98.2%. Within-run precision was 4.2% and between-run precision was ~5.4%. Conclusion The result indicated that the method was an effective method for clinical and scientific research with advantages of rapidity, simplicity and accuracy.