Objective: To establish a method for the determination of paracetamol, caffeine and chlorphenamine maleate in Compound Ganmaoling Tablets. Methods: The RP-HPLC was conducted on a Phenomenex C 18 column(5?m,250mm?4.0mm) with methanol: water: acetic acid(35∶65∶1.5) as a mobile phase, detect wavelength at 270nm. Results: Paracetamol, caffeine and chlorphenamine maleate respectively showed good linear relationship in the following concentrations of ranges:50.4～117.6?g?mL -1,3.6～8.4?g?mL -1,0.84～1.96?g?mL -1; The average recoveries were obtained as 99.9%,99.8%,100.0%(n=6); respectively. Conclusion: The method was simple, sensitive, accurate and suitable for the determination of three constituents in Compound Gamaoling Tablets.

Mixed-ownership hospitals constitute an experiment of such ownership in the health care sector,attracting high attention as of its birth.This paper introduced the background of such ownership,and analyzed the development of such hospitals in terms of policy,present situation and external effects.The authors,arguing against major challenges,stated their views on such hospitals along with in-depth analysis of key issues in their development.

Based on a field survey of typical hospitals in Zhejiang,this paper drew a conclusion on three models of the mixed-ownership hospitals development in Zhejiang.It summed up the experiences learnt in the practice about how to maintain the public welfare of the public hospitals,how to ensure the essential health services supply as well as the incentive mechanism for social capital.Suggestions were proposed to develop the mixed-ownership hospitals based on the analysis.

Objective:To study the expression and clinical significance of GPRC5A and SOCS3 in colorectal carcinoma.Methods:SP immunochemical method was performed to detect the expression of GPRCSA and SOCS3 in 45 cases of colorectal carcinoma,25 cases of colorectal adenomas and 22 cases of normal colorectal tissues.Results:1)Expression of GPRC5A in colorectal cancinoma tissue (22.2％) was significantly lower than that in adenomas tissue (52.0％,P＞0.05).The Latter was significantly lower than that in normal colorectal tissue (81.8％,P＜0.05).GPRC5Awas closely related to lymph node metastasis,Duke's stages and the deepness of invasion (P＜0.05).2) Expression of SOCS3 in colorectal cancinoma tissue (24.4％) was significantly lower than that in adenomas tissue (56.0％,P＜0.01).The Latter was significantly lower than that in normal colorectal tissue (86.4％,P＜0.05).SOCS3 was closely related to pathological differentiation,the deepness of invasion,Duke's stages and lymph node metastasis (P＜0.05).3)The expression of GPRC5A was positive correlated with SOCS3 (P＜0.05).Conclusions:The reduced expressions of GPRC5A and SOCS3 may participate in the occurence and development of colorectal carcinorma,suggesting that GPRC5A and SOCS3 may act as biological markers for evaluating the malign degree,prognosis and therapeutic targets of colorectal carcinorma.

Objective To compare the efficacy of laparoscopic and conventional open total mesorectal excision (TME) in the treatment of rectal cancer, and to explore the considerations of laparoscopic TME. Methods 75 cases of laparoscopic group and 61 cases of open surgery group were analyzed retrospectively, and cohort study was used to compare the perioperative indicators and clinicopathological results in the two groups. Results Between the laparoscopic group and the open surgery group, the operative incision [8.7 cm (8.0-10.0 cm) vs. 13.6 cm (10.0-16.0 cm)], the use of postoperative analgesics (8 cases vs. 23 cases), postoperative time to remove the drainage tube [5 d (5-6 d) vs. 6 d (6-8 d)], postoperative time to get out of bed [3 d (3-7 d) vs. 5 d (4-8 d)] and postoperative hospital stay time [6 d (5-18 d) vs. 8 d (6-25 d)] had statistical difference (all P<0.05). The cost of laparoscopic group was higher than that of open surgery group (each patient in laparoscopic group spent more about 7 000 yuan than ones in open surgery group ). There was a significant difference in the overall complication rate between the laparoscopic group and the open surgery group [6.7 % (5/75) vs. 13.1 % (8/61), P<0.05]. Conclusions The postoperative analgesics, removal of drainage tube time, hospital stay and other indicators in the laparoscopic TME are superior compared with those in the open surgery, but due to the use of high-value consumables, the cost of laparoscopic surgery is higher. Besides, laparoscopic resection of rectal cancer should be careful.

Objective To determine the perioperative risks of partial hepatectomy by determining the preoperative liver functional reserve in patients with hepatocellular carcinoma (HCC),and to compare the model for end-stage liver disease (MELD) score with the Child-Pugh classification in predicting prognosis.Methods We reviewed the clinical data of 202 patients with HCC who underwent partial hepatectomy.The MELD score and the Child-Pugh classification were determined preoperatively.Results The incidence of postoperative liver dysfunction happened in 44.0％ of Child A patients,50％ in Child B patients,41.6％in patients with a MELD score below 14,and 91.7％ in patients with a MELD score of ＞ 14.The difference between the rates of postoperative liver dysfunction in patients with a preoperative MELD score above 14 and below 14 was significant (P ＜ 0.05),while that between patients with Child-Pugh A and B was insignificant (P ＞ 0.05).The incidences of postoperative liver dysfunction in patient with a MELD ＜ 8,8 ≤ MELD ≤ 14,MELD ＞ 14 were 38.2％,57.6％ and 91.7％,respectively,indicating that there was a positive co-relationship between the MELD score and the incidences of liver dysfunction.The Spearman rank correlation test showed the MELD score was significant correlated with the Child-Pugh score (r =0.404 ; P ＜ 0.05).The areas under the ROC curves of the MELD score and the Child-Pugh score were 0.703 and 0.587 (P ＜ 0.05).Conclusions The MELD score predicted postoperative liver dysfunction more accurately than the Child-Pugh classification.HCC patients undergoing partial hepatectomy with a preoperative MELD score ＞ 14 had a high perioperative risk.To ensure the safety of partial hepatectomy,HCC patients with a preoperative MELD score ＞ 14 requires active preoperative preparation,bringing the score near to or less than 14.

Objective:To study the effects of dexamethasone,cyclophosphamide,cyclosporin A and mycophenolate mofetil on the expression of Dectin-1 and TLR2 receptor in RAW264.7 cell line.Methods:In vitro culturing RAW264.7 macrophages ,the cells were given different doses of dexamethasone and cyclophosphamide ,cyclosporin A and mycophenolate mofetilfor 24 h.The influence of different immunosuppresants on cell proliferation was detected by CCK-8 assay.Dectin-1,TLR2 mRNA and protein levels of change were detected with RT-PCR technique and flow cytometry .Results:CCK-8 cell proliferation toxicity experiment results showed that with the increase of the dose of dexamethasone ,cyclophosphamide ,Cyclosporin A and mycophenolate mofetil ,the different degree of inhibi-tion of RAW264.7 cell proliferation in mice can be saw after the intervention of 24 h (P<0.05).After 24 h of dexamethasone stimula-tion,Dectin-1 mRNA and protein level decreased,TLR2 mRNA and protein levels elevated (P<0.05).However cyclophosphamide had no obvious influence on Dectin-1 and TLR2 ( P>0.05 ) .Mycophenolate mofetil and cyclosporin A could both inhibit the expression of Dectin-1 and TLR2 (P<0.05).Conclusion:There are significant differences among the regulatory functions of various immunosupres -sants on the expression of pattern recognition receptors .Different immunosuppressive agents exert their inhibitory effects on immune rec-ognition process of fungal pathogens not only by selectively regulating their target PRRs expression ,but also by inhibiting the growth and proliferation of macrophages .

OBJECTIVETo compare the clinical outcomes of anterior cervical decompression plus sublevel fusion and posterior cervical laminoplasty in treating multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 56 patients with multilevel cervical spondylotic myelopathy were retrospectively analyzed from July 2009 to June 2012. There were 32 males and 24 females, aged from 42 to 79 years old with an average of (56.9 +/- 12.8) years. All patients had the typical clinical features of cervical spondylotic myelopathy,radiological evidences, and courses of disease were from 2 months to 16 years with an average of (10.6 +/- 3.2)years. Of them,34 patients were treated with anterior cervical decompression plus sublevel fusion (anterior fusion group) and 22 patients with posterior cervical laminoplasty (posterior laminoplasty group). JOA score and radiological data were used to evaluate the clinical results:

RESULTSNo complications about nerve and blood vessel was found and the patients were followed up from 24 to 36 months with an average of 28.6 months. In anterior fusion group, the cervical anterior column height was significantly increased and the anterior cervical curvature angle was significantly decreased at 2 weeks after surgery (P < 0.05). In posterior laminoplasty group, there was no significant difference in above items between preoperative and postoperative at 2 weeks,final follow-up. Postoperative at 2 weeks and final follow-up, there was significant difference in anterior cervical curvature angle between two groups (P<0.05). Postoperative JOA score had obviously improved in all patients, at 3 months after operation and final follow-up, anterior fusion group was better than that of posterior laminoplasty group (P < .05).

CONCLUSIONThe anterior sublevel fusion can effectively restore cervical anterior column height, and compared with the posterior cervical laminoplasty, it can obviously improve the spinal cord function. It is an effective method for the multilevel cervical spondylotic myelopathv.

Adult ; Aged ; Case-Control Studies ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spinal Fusion ; Spondylosis ; diagnostic imaging ; surgery

OBJECTIVETo compare therapeutic effects between patella replacement and patella osteotomy in total knee arthroplasty.

METHODSFrom April 2004 to April 2011, 52 patients (54 knees) were enrolled in the clinical trail of total knee arthroplasty, who received patella replacement (24 knees, including 13 males and 11 females,ranging in age from 53 to 78 years old or patella osteotomy (30 knees,including 16 males and 12 females,ranging in age from 55 to 79 years old. The average follow-up period was 56 months,ranging from 20 to 80 months. The American HSS Score for knee, the Feller score for patella, range of motion (ROM) for knee, patient satisfaction and complications related to the patella were used to evaluate therapeutic effects.

RESULTSIn the patella replacement group,the preoperative and final follow-up HSS scores of patients were 38.4 +/- 8.2 and 91.2 +/- 8.6 respectively; Feller scores were 13.6 +/- 6.2 and 25.2 +/- 4.2; scores of anterior knee pain were 3.9 +/- 3.2 and 11.2 +/- 3.7; ROM were (78 +/- 26) degrees and(108 +/- 18) degrees. In the patella osteotomy group,the preoperative and final follow-up HSS scores of patients were 39.5 +/- 8.4 and 91.0 +/- 8.5 respectively;Feller scores were 13.4 +/- 6.5 and 25.6 +/- 4.0; scores of anterior knee pain were 3.7 +/- 3.1 and 11.3 +/- 3.6; ROM were (76 +/- 27) degrees and (110 +/- 19) degrees. In the patella replacement group,patient's satisfaction was 91%, and complication related to the patella was 16.7%; in the patella osteotomy group, patient's satisfaction was 89%, and complications related to the patella was 10.0%. There were no statistically significant differeneces in final follow-up HSS scores, Feller scores, scores of anterior knee pain and ROM between the two groups. However,there was no significant difference of patient's satisfaction between them. There was statistically significant differenece of patella-related complications between the two groups, and the complication rate in the patella replacement group was higher than that in the patella osteotomy group.

CONCLUSIONTotal knee arthroplasty with patella replacement or patella osteotomy dramatically relieves pain and improves the knee function. Patella-related complications are associated with its treatment methods, but post-operative anterior knee pain and patient's satisfaction are not related to treatment methods of the patella.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Case-Control Studies ; China ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteotomy ; adverse effects ; Pain, Postoperative ; epidemiology ; etiology ; Patella ; surgery ; Treatment Outcome

Objective To analyze the CT appearances and the classification of gray matter heterotopia.Methods The clinical and CT data of 26 cases with gray matter heterotopia were retrospectively reviewed,11 were males and 15 were females,ranged in age from 2 days to 9 years with a mean of 2.6 years.Results The classification of heterotopia included:(1)Subependymal heterotopia in 14,5 cases with encephaloceles,1 case with Dandy-Walker malformation and 1 case with arachnoid cyst of cisterna megna.(2)Subcortical heterotopia in 7,4 cases with callosal agenesis were accompanied.(3)Band heterotopia in 5.Conclusion CT scan can not only reveal the appearances of the subependymal,subcortical and band types heterotopia,but also show other associated abnormalities.