OBJECTIVE:To establish a method for the contents determination of tetrahydropalmatine and rosmarinic acid in Xiaoheling capsule. METHODS:HPLC was performed on the column of Phenomenex C18 with mobile phase A of 0.1% phosphoric acid(adjusted pH to 6.0 with triethylamine)-methanol(45:55,V/V) and (adjusted pH to 6.0 with triethylamine) B of 0.1% phos-phoric acid-methanol(55:45,V/V)(gradient elution)at flow rate of 0.8 ml/min,detection wavelength was 282 nm(0-25 min)and 330 nm(25.01-60 min)and volume size was 10 μl. RESULTS:The linear range was 1.502-75.10 μg/ml for tetrahydropalmatine and 6.03-301.6 μg/ml for rosmarinic acid(r=0.999 8);RSDs of precision,reproducibility and stability tests were ≤1.36%;recoveries were 97.11-99.87%(RSD=0.95%,n=9)and 98.47-101.99%(RSD=1.08%,n=9),respectively. CONCLUSIONS:The method is simple,accurate and reliable,and can be used for contents determination of tetrahydropalmatine and rosmarinic acid in Xiaoheling capsule.

Objective To explore the feasibility and safety of endoscopic thyroidectomy via axillo-breast approach and the cervical strap muscles. Methods From January to June 2007, endoscopic thyroidectomy was performed on 21 cases in our department via axillo-breast approach and the cervical strap muscles. The operation was carried out under general anesthesia, the anterior cervical muscles was preserved and dragged ahead if necessary. The pressure of CO2 at surgical space was set at 6-8 mm Hg.Results Endoscopic unilateral partial or subtotal thyroidectomy was completed in all the patients without converting to open surgery. No complication occurred in this series. The mean operation time was 70-120 min [mean,(88.3?19.5) min], and the mean blood loss was 2-100 ml [mean, (11.5?21.8) ml]. The drainage tube was removed at 36-48 hours after the operation. And the mean postoperative hospital stay was 2 days. A 3-month follow-up showed good outcomes in terms of sensation at the surgical region and cosmetic effect. Conclusion Endoscopic thyroidectomy via axillo-breast approach and the cervical strap muscles is feasible and safe for unilateral benign thyroid lesions.

Objective To evaluate the safety and feasibility of laparoscopic distal pancreatectomy.Methods From September 2005 to June 2008,26 patients with masses located at pancreatic body/tail were treated in our hospital.Before the operation,25 of the cases were diagnosed with benign tumor and one was suspected as having malignant neoplasm.The median size of the tumors was 5 cm in diameter(range,1.2 to 10 cm).Results All of the operations were completed by laparoscopy.Distal pancreatectomy was performed on 15 patients with the spleen being preserved with(10 cases)or without(5)splenic vessels preservation;and laparoscopic distal splenopancreatectomy was carried out in 10 cases.In one patient who had received open distal splenopancreatectomy before admission,resection of the pancreatic body was made.The median operation time was 268.5 minutes in this series(range,129 to 400 minutes),and the median intraoperative blood loss was 100 ml(range,50 to 800 ml).The patients were discharged in 6 to 21 days postoperation(median,9 days).None of them developed pancreatic fistula or splenic infarction.Two of the patients developed encapsulated fluid and were cured by conservative treatments,one patient showed incisional infection.Follow-up was available in all the patients for 1 to 35 months(median,15.5 months).During the period,no recurrence was detected.Conclusions Laparoscopic distal pancreatectomy is feasible and safe for benign tumors located at the body or tail of the pancreas.

Objective To investigate curative effects of interventional therapy,palliative operation,and palliative operation combined with ~(125)I seed implantation for the treatment of advanced pancreatic carcinoma.Methods A total of 103 patients with unresectable pancreatic cancer were treated with percutaneous transhepatic cholangiography and drainage(Interventional Group,15 patients),or cholangiojejunostomy and gastroenterostomy(Palliative Group,60 patients),or palliative operation combined with ultrasound-guided ~(125)I seed interstitial implantation(Combination Group, 28 patients),respectively.Results Of 21 patients with preoperative pain in the Combination Group,the rate of partial pain relief and complete pain relief were 14.3%(3/21) and 76.2%(16/21),respectively,which were significantly higher than those in the other two groups(?~2=6.305,P=0.012;?~2=4.525,P=0.033).The median survival time was significantly longer in the Combination Group(8 months) than in the Palliative Group(7 months) and the Interventional Group(2 months)(P=0.0005).Conclusions Percutaneous transhepatic cholangiography and drainage can be applied to patients who cannot tolerate open surgery.Conventional palliative operations combined with ~(125)I seed implantation benefits the patients both in survival time and in pain relief.

Objective To investigate the feasibility and efficacy of ultrasound-guided interstitial implantation of radioactive ~(125)I seed for the treatment of unresectable pancreatic carcinoma.Methods Twenty-one patients with unresectable primary pancreatic carcinoma were treated with interstitial ~(125)I seed implantation under laparotomy.The radioactive activity and the number of implanted seed were determined according to preoperative CT scanning outcomes by using the Treatment Planning System(TPS).The matched peripheral dose(MPD) was 65~110 Gy.The radioactive activity ranged 0.4~0.5 mCi per seed.A total of 10~75 ~(125)I seed were implanted with an 18-gauge seed needle and the Mick applicator under direct visualization or ultrasound guidance.Gastroenterostomy or cholangiojejunostomy were performed in 8 patients before or after the implantation.Postoperative external radiation therapy combined with chemotherapy with gemcitabine was carried out in 2 patients. Stent placement was conducted in 2 patients preoperatively and postoperatively, respectively.Results Out of 15 patients with abdominal pain,complete and partial pain relief were obtained in 7 patients and 7 patients,respectively,at 1~3 postoperative days,the response rate being 93.3%(14/15). Except for 2 cases of loss of follow-up,there were 5 cases of complete response(CR),7 cases of partial response(PR),5 cases of progressive disease(PD),and 2 cases of no change(NC).Of 19 patients,the median survival time was 5 months and the 1-year survival rate was 26.3%.Chylous leakage occurred in 1 patient and seed dislodgement to the liver occurred in 3 patients.No pancreatic fistula or pancreatitis were encountered. Conclusions Radioactive ~(125)I seed implantation for the treatment of pancreatic carcinoma is safe,effective,and micro-invasive,being a good option of remedy.

Objective:To investigate the gross motor function, manual ability and language communication of children with cerebral palsy (CP) and their correlation.Methods:A total of 318 children with CP (132 with spastic diplegia, 27 with spastic quadriplegia, 32 with spastic hemiplegia, 54 with dyskinesia, 41 with ataxia and 32 children with multiple difficulties) aged 4 to 12 years were classified according to the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). Spearman correlation coefficients were used to analyze the correlation among the three ratings.Results:Only 125 of the 318 children (39%) had the same classification level according to all three scales, showing moderate correlation and different levels for patients with different types of disability. The GMFCS and MACS levels of the subjects with spastic quadriplegia and those with dyskinesia were highly correlated. The GMFCS and CFCS levels of the hemiplegic children and those with spastic quadriplegia were also highly correlated. The MACS and CFCS levels were strongly correlated for children with spastic quadriplegia and multiple disabilities.Conclusions:The functioning of children with CP differs with their CP subtype. Correlations among the three functional assessments also differ for children with different subtypes. Combining the three classification systems provides a more comprehensive picture of the children′s ability to function in daily life.

Objective: To investigate the clinical results of permanent implantation of radioactive 125 I seeds in treatment of advanced pancreatic adenocarcinoma.Methods:Eight patients with advanced pancreatic adenocarcinoma were treated with 125 I implantation from May 2002 to December 2002 and the data was retrospectively analyzed.Results: The mean number of 125 I seeds implanted was 22.8 with minimum of 19 to maximum of 38 each. The matched peripheral dose was 65 Gy.The postoperative courses were uneventful and no bone marrow suppression was recorded.The preoperative efractory abdominal and back pain in 2 patients were relieved completely (2/2).The postoperative CT scan which were done in four cases showed that tumor disappeared completely in 2 cases,were well locally controlled in 1 and slightly controlled in one.No acute pancreatitis and pancreatic leakage were encountered in all patients.Conclusion: The implantation of radioactive 125 I was effective in local control of the tumor and pain relief and is a safe alternative for the treatment of unresectable pancreatic adenocarcinoma.

Objective To study the clinical features of visual dysfunction in children with cerebral palsy (CP) and related factors. Methods Between 2006 and 2009, one hundred and sixty-three children (aged 4 to 108months, mean age 29.05 ± 20.51 months) with CP at Qingdao's Rehabilitation Center for Disabled Children were enrolled into this study, including 117 boys and 46 girls. All the children were retrospectively reviewed for perinatal risk factors. Ophthalmologists examined their visual parameters, including refraction, visual acuity, eye position and movement, and fundoscopy. Results Among the 163 children, 61 had visual dysfunctions, an occurrence rate of 37.4%. They included refractive errors in 39 (23.9%) , strabismus in 50 (30.7%) , abnormal eye movement in 26(15.9%) , and abnormal fundoscopic findings in 13 (7.9%). Thirty-seven children's visual acuity was examined,and 19 of them (51.4%) had low visual acuity. Patients who showed periventicular leukomalacia (PVL) or lesions in the occipital lobe on MRI examination had a high incidence of visual dysfunction. Preterm and low birth-weight were risk factors for visual dysfunction in these CP children. Conclusions Visual dysfuntion is a common complication in CP children. Early ophthalmological assessment and intervention are important for CP children.

Objective To study the safety and feasibility of laparoscopic distal pancreatectomy in different modalities.Methods From September 2005 to October 2012,57 patients with masses located at pancreatic body/tail were treated by laparoscopic distal pancreatectomy.According to the operation procedure,patients were divided into four groups:distal pancreatectomy with splenectomy; Spleenpreserving distal pancreatectomy with conservation of the splenic artery and vein; spleen-preserving distal pancreatectomy and without conservation of the splenic artery and vein and laparoscopic to open distal pancreatectomy.Data of each group for operation time,blood loss and complications were collected and statistically analyzed.Results In 57 patients,5 cases were converted to open distal pancreatectomy.52 cases underwent successful laparoscopic operation (including 1 cases of hand-assisted).22 cases of spleen preserving operation (39％),and 30 cases of splenectomy operation (61％).Among the 4 groups of patients operation time,intraoperative blood loss,postoperative length of stay were not significantly different (all P ＞ 0.05).There was no operative mortality.Two cases suffered from B level postoperative pancreatic leakage,there was no C level pancreatic leakage.Conclusions Laparoscopic distal pancreatectomy with or without splenectomy is safe for the treatment of body and tail tumors of the pancreas.

Objective To explore the clinical aspects and related EEG characteristics of epilepsy (EP) in children with cerebral palsy (CP).Methods The clinical data and the EEG Results of seizure-interictal-period in 84 CP children complicated with EP were collected and compared with the data of 124 CP children without EP.Results Among 84 CP children complicated with EP, 46 cases (54.76%) were partial seizures. Followed 26 cases (30.95%) were infantile spasms, 6 cases (7.14%) were tonic-clonic seizures. Spastic CP children tended to be the most patients seizures in EP, it was 82.14%. Children with teraplegia CP were the most type among the spastic CP children compliated with EP. The abnormal rate of EEG of CP children complicated with EP was significantly higher than that of CP children without EP ( P＜0.001), and local epilptiform discharges and multilocal epileptiform discharges were main types.Conclusion Partial seizures is the most epilepsy type in CP children complicated with EP, and spastic CP is the main type. EEG abnormal ratio is obviously higher in the CP children complicated with EP than the CP children without EP. The types of abnormal EEG are mainly local epilptiform discharges and multilocal epileptiform discharges.