Severe clubfoot has complicated clinical features.Conventional surgical management could hardly get satisfactory results,always with serious trauma,and even smaller foot.This paper summarizes the characteristics of clubfoot in details and its relative assessment standard,principles and advantages of Ilizarov's technique,design of the apparatus and correction procedures.Combination of this and traditional technique and reasonable osteotomy method are also analyzed,complications are discussed for prevention.

Four diterpenoid alkaloids were isolated from Aeonitum longtounens T. L. Ming grown in Lijiang of Yunnan Province, for the first time. They were identified as foresaconitine, chasmaconitine, delsoline and delcosine by Physical contants and spectral data.

The present paper reports the distribution of ALADH phenotypes in 170 Chinese peoples living in Nanjing area by means of the mixed starch get electrophoresis. The gene frequencies are ALADH~1=0. 359, ALADH~2=0.641, which are compared with the gene frequencies of some other countries.

OBJECTIVE:To understand the situation of essential medicines and promote their rational use in our hospital. METHODS:The prescription variety and cost percentages of essential medicines in outpatient department in the two halves years of 2013 in our hospital(eye and ENT specialized hospitals)were compared;the medicines with forefront prescription kind percent-ages in eye and ENT departments were sorted and rankings in 4 quarters were compared. RESULTS:After the approval of the Na-tional Essential Medicine List(2012 edition),compared with the first half year of 2013,prescription variety and cost percentages of essential medicines in outpatient department in the second half year were significantly increased (P<0.01). Prescription variety and cost percentages of essential medicines in eye department in the second half year were significantly increased(P<0.01),in the top 20 prescription variety,totally 2 kinds were contained by the list 2012 edition and 3 were contained by the supplementary list of Shanghai(2012 edition). Compared with the first half year of 2013,prescription variety and cost percentages of essential medi-cines in ENT department in the second half year were significantly decreased(P<0.01),the cost percentage was significantly in-creased(P<0.01),in the top 20 prescription variety,totally 2 kinds were contained by the list 2012 edition and 3 were contained by the supplementary list of Shanghai (2012 edition). CONCLUSIONS:The prescription variety and cost percentages of essential medicines in our hospital show increase trend. Nevertheless,the non-essential medicines are still dominant and further improvement of essential medicines is still needed. Medicine variety and dosage forms of eye in ENT department are insufficient concluded in Es-sential Medicine List. Further adjustment of Essential Medicine List still needs more consideration for the medication characteristics in specialized hospital.

We retrospectively analyzed 218 allergen skin prick tests ( SPT ) of the patients with chronic sinusitis with or without nasal polyps( CRSwNP/CRSsNP) before the operation. The proportions of positive SPT in CRSwNP and CRSsNP were compared respectively. The distributions of allergens were the same in all groups. The positive rate of SPT in CRSwNP was higher than that in CRSsNP, with statistical significance(P<0. 05). The positive rate of SPT in CRSsNP was higher than that of the control group, without statistical significance. The recurrence rate in CRSwNP was higher than that in CRSsNP, with statistical significance. The recurrence rate in the allergen-positive patients was higher than the allergen-negative patients, with statistical significance.

Objective To define the risk period of acute pancreafifis-associated lung injury (APALI) by aserial study including a dynamic changes in total water content of lung, ultrastructure and number of type Ⅱ alveo-lar epithelial, and reactive oxygen metabolisms (ROMs) of lung tissue in mice with severe acute pancreatits (SAP)and a clinical analysis of APALI patients. Method ICR mice were selected to establish SAP model. The animalsreceived 7 intraperitoneal injections of caerulein (50 μg/kg body weight) at hourly intervals followed by intraperi-toueal injection of lipopolysaccharide (15 mg/kg body weight). The total water content, uhrastrueture and numberof type Ⅱ alveolar epithelial cells, and ROMs of lung tissue were detected before (0 h) and 6 hours, 12 hours,lday, 4 days and 7 days after SAP model establishment, respectively. In addition, 215 patients with APALI (PaO2< 60 mmHg) collected from the First Affiliated Hospital of Zhejiaug University between January 1998 and Decem-ber 2006 were analyzed. Statistical analysis were performed by using F-test. P-values less than 0.05 were regardedas statistically significant. Results The total water content and ultrastructure mitochondria and lamellar bodies intype Ⅱ alveolar epithelial cells of lung in SAP mice were significantly altered at 12 hours after SAP model estab-lishment, and reached maximum at 1 to 4 days later. A decrease in number of type Ⅱ alveolar epithelial cells andincrease in ROMs reached a maximum at 1 day after SAP model establishment. Furthermore, the results of clinicalstudy showed that the lung injury occurred at (3.1435±1.0199) days after SAP. The data were almost consistentwith the resalts from SAP model. Conclusions The risk period of APALI occurres between the 1st day and the4th day during the course of SAP.

Molecularly imprinted polymer (MIP) was synthesized by precipitation polymerization using ribavirin as the template molecule and methacrylic acid as the functional monomer.The sensitive film of ribavirin electrode was constructed by molecularly imprinted polymer doped with graphene oxide as the ionophore, poly(vinylchloride) (PVC) as matrix and dioctyl sebacate for plasticizer.The results showed that the best performance of the electrode was obtained when the sensitive film compositions were 100.8 mg of MIP, 14.7 mg of GO, 450.8 mg of PVC and 901.6 mg of dioctyl sebacate, and the inner filling solution composition was 0.1 mol/L NaCl + 0.05 mol/L NaAc-0.05 mol/L HAc + 1.0×10.-5 mol/L ribavirin solution.The electrode showed a near-Nernstian slope of 45.565 mV/decade for ribavirin over the range of 1.0×10.6-1.0×10.-4 mol/L and a detection limit of 1.0×10.-7 mol/L.The electrode could be used in the pH range of 3 to 5 with response time of less than 3 min.The developed electrode exhibited high selectivity for ribavirin and was successfully applied to the determination of ribavirin in feed and injection with recoveries of 90%-110% and RSD of 3.0%-7.9%.

Objective To explore the application of the Ilizarov's principle on tension-stress in correction of adult severe talipes equinovarus. Methods From January 1996 to February 2003, 12 patients (13 feet) were corrected with this method, which involved 9 males and 3 females, whose average age was 26 years old (ranged from 20-36 years). The left foot was afflicted in 4 patients, and the right foot in 7, both side in 1. Among these patients, 3 were congenital, 6 were caused by the poliomyelitis, 1 by trauma, 1 by complication from encephalitic paralysis and 1 by radiotherapy for the cavernous hemangioma of the leg. The Ilizarov distraction apparatus of the ankle and foot joint were equipped in terms of the diseases preoperatively. During the operation, the release of the postero-medial soft tissue and the limited osteotomy of triple joints of the clubfoot were performed. According to the principles of Ilizarov, the wires were inserted and the fixator installed, the distraction devices of the ankle and foot joint which had corrective function in three-dimensional directions were applied to the tibia and foot, the telescopic rods on the apparatus were rotated one week after the operation. The deformity of talipes equinovarus, internal rotation and the drooping of the forefoot were gradually corrected, and the patients could bear weight and walked on the deformity foot during the course of distractive correction. Results All the 12 patients were available at follow-up with a mean duration of 15 months (ranged from 7 months to 4 years). There was no recurrence of the deformity and the feet function was good while walking on full weight-bearing. The mean duration of traction was 71 days. 10 patients (11 feet) could gain 0? in full weight-bearing, 2 patients preserved the drooping feet deformity at 15?-20? (because of shortness in the lower extremety). None of the complications occurred postoperatively, such as infection in the incision or pin tract, necrosis of the flap, neurovascular injury and nonunion. Conclusion Utilizing Ilizarov's principle on tension-stress to correct severe adult talipes equinovarus is a safe, minimally invasive and effective method.

In order to arouse the working enthusiasm of the entire staff and give expression to the value of labor and skills, our hospital has implemented reform in the distribution system. Bonus given to clinical departments is linked both to the amount and quality of work and to economic profits; bonus to medico technical departments is given by means of deducting a percentage from the income and expenditure surplus in a way of progressive decrease; bonus given to functional departments is equivalent to 90% of the average bonus given to medical service departments; and bonus to logistical service departments is given, if possible, by the piece and mark. As a result of the reform, the distribution system has become more rational, the working enthusiasm and efficiency of the staff have been enhanced, operational income and income structure have improved, and social benefits bave been raised, with the satisfaction rate reaching over 90%. Of course, there still exist some difficulties in the reform.

ObjectiveTo evaluate surgical management of femoral pseudoaneurysm caused by injection of addictive drugs.MethedsData of 18 cases were reviewed and analysed retrospectively.13 patients underwent primary expanded polytetrafluoroethylene(ePTFE) external iliofemoral bypass (end to side) grafting. Postoperative anastomotic burst and bleeding in one of the 3 patients undergoing saphenous vein autotransplant in situ was successfully treated by ePTFE grafting. Results All of the grafts were patent as demonstrated by postoperative color Dopler ultrasonography. Although 2 patients had their femoral arteries ligated, limbs of all the 18 patients were salvaged.ConclusionsWhen a suitable saphenous vein is not available for autotransplantation, an artificial vessel grafting is still an effective procedure for managing femoral artery false aneurysm.During operation thorough debridement and avoidance of artificial vessel contamination are the most important factors for preventing infective complications of the graft.