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.

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.

Objective To introduce a new computer-assisted external frame for osteotomy to correct complex tibial and fibular deformity.Methods From January 2012 to December 2013,15 patients with complex tibial and fibular deformity were treated with a computer-assisted external frame and related computer software for surgical correction.All were unilateral limb deformity,involving the left lower limb in 8 cases and the right lower limb in 7 cases.They were 8 males and 7 females,15 to 43 years of age (average,26.8 years).The deformity was caused by old osteomyelitis in 9 cases and trauma sequela in 6.The related angles,distances and rotations were measured on the postoperative radiographs of the lower limbs.The data were input into the software to calculate the daily adjustment lengths of the frame rods.Daily frame adjustments were conducted according to the data calculated.The frame was removed when expected results were achieved.The patients lived independently during the adjustment.Results The 15 patients were effectively followed up for 10 to 22 months (average,15 months).Frame fixation time averaged 8.4 months (from 5.5 to 13.1 months).The reunion time averaged 8.0 months (from 5.4 to 12.1 months).The hospitalization time averaged 2.4 months (from 2.0 to 2.8 months).In 10 cases of limb shortening,the shortening lengths averaged 0.5 cm (from 0 to 0.9 cm) after adjustment.In 12 cases of angulation deformity,the angulation averaged 3.3° (from 0° to 5.4°) after adjustment.In 5 cases of rotation deformity,the maximum internal rotation was 5° and the maximum external rotation 10° after correction,deviating from the normal values by 3.5° on average.In 6 cases of horizontal displacement,the displacements averaged 0.5 crn after correction.All patients were satisfactory with corrected lower limb alignment,improved symptoms and appearance,giving a subjective satisfaction rate of 100％.Conclusion Use of computer-assisted external frame in surgical correction of tibial and fibular deformity can achieve satisfactory outcomes in simple,accurate,standardized,minimally invasive manners.

Objective To establish a method to isolate and cultivate rat bone marrow mesenchymal stem cells (BMSCs),and explore the feasibility of labeling in vitro,and tracing in vivo,BMSCs with chloromethyl-benzamidodialkylcarbocyanine (CM-Dil). Methods BMSCs were obtained and subsequently cultured with whole bone marrow cell culture system,and the third generation of BMSCs was harvested. The positive rates of CD34,CD44 and CD29 were detected by flow cytometry. CM-Dil was used to label BMSCs in vitro and the efficiency of labeling after 24 hours and at day 21 and 30 were examined under fluorescent microscope. Moreover,the growth curves were sketched to determine the negative effects of CM-Dil on the vitality and proliferation of BMSCs cultured in vitro. Rat model of focal cerebral ischemia was reproduced,CM-Dil labeled BMSCs were implanted into corpus striatum of rats' brain with computer-guided stereotaxis thereafter. Brain tissues were obtained to prepare frozen sections at 7th,14th and 21st day post-implantation,and the survival and distribution of labeled cells were observed with fluorescent microscopy. Results The third generation passage of cultured BMSCs grew orderly,with shape of desmocytes,and homogeneous in morphology. The positive rates of CD34,CD44 and CD29 expressions in BMSCs were 1.71%,80.32% and 84.89%,respectively. Red fluorescence was observed in CM-Dil labeled BMSCs in vivo 24 hours after labeling,with a positive rate of 100%. The fluorescence intensity of passage cultured BMSCs observed on day 21 was similar to that observed at 24 hours after labeling,but diminished on day 30. The growth,proliferation and morphology of BMSCs,were not influenced by CM-Dil labeling. On day 7,14 and 21 post-implantation,BMSCs decreased in quantity,appearing in oval or irregular shapes,and most of the cells were found around the needle tract,with a tendency of diffusion to peripheral area. Conclusion High purity of BMSCs may be obtained with whole bone marrow cell culture system from bone marrow of rats. CM-Dil labeling is easy to handle and effective,with no cytotoxicity to cells. The latest labeling period of CM-Dil is 21 days in vitro,therefore it seems to be an effective method for in vivo tracing of BMSCs in brain after implantation.

[Objective]To study the safety,clinical effect and therapeutic characteristics of distraction apparatus for correcting flexion contracture deformities of the knee joint by evaluating the clinical outcomes and investigating the results of biomechanic test.[Method]Forty-nine patients (included 52 knees) were treated by the standardized distraction apparatus and the comprehensive assessment standard was adopted to evaluate the clinical outcomes.Five patients were examined by three-dimensional CT of the knee joints pre-operatively and post-operatively to observe the changes in the knee structure.To observe the effect of distraction on the popliteal artery and the limb nerves,the popliteal artery diameter and blood flow speed were examined in 15 patients and the regio cruris electromyogram and nerve conduction velocity were examined in 6 patients before and after treatment.Three different means of distraction and measurement were underwent in 3 patients so as to observe the changes in the flexion curve and force of posterior soft tissues of the knee.[Result]All patients (52 knees) regained congruous structure and better function,the final excellent and good result rate was 65%.Three-dimensional CT examination of 5 patients showed that the postoperative knee joint structures were superior to the preoperative ones and there weren't damage of articular surface.The statistic results indicated that the popliteal arteries weren't obviously disturbed by distraction,whereas the limb nerves were probably disturbed temporarily.Three methods of distraction and measurement in 3 patients showed different outcomes,indicating that the effect of distraction on soft tissues was influenced by the distraction method,the ages of patients and the extents of deformities of the limb.[Conclusion]The distraction speed of therapeutic method is safe,reasonable and effective in correcting flexion contracture of the knee joint;The distraction force on posterior soft tissues of the knee is influenced by various elements,thus,the distraction speed should be individualized.Low-load and steady stretch are advantageous to soft tissue regeneration and safer.

[Objective]To explore the methods and effect of using Ilizarov'techniques for correcting severe flexion contracture of the knee joint.[Method]According to Ilizarov's tension-stress principle and its applying technique,the knee joint distraction apparatus was designed and fixed individually.The joint hinges of the apparatus on the two sides were consistent with the rotational center of the knee joint.Joint distraction of 5 to 10 mm was initially performed and followed by gradual correction of the knee joint flexion contracture at an average rate of 1 mm per day at the level of the knee joint by turning the nuts on the distraction rods at 3～4 rounds per day,with the distraction rate modified according to the patient's tolerance.Regular x-ray exams should be carried out to prevent knee joint dislocation and compression of the articular cartilage.The final requirement of correcting the soft tissue flexion deformity of the knee joint was to overcorrect the joint deformity into 5～10 degrees of hyperextension.As for the joint flexion with anterior bowing deformity of the distal femur,the degree of correcting the knee joint flexion contracture should deduce the degree of the bony deformity.The frame was left on for an additional 2 to 4 weeks.When the frame was removed,the knee joint was immediately casted in full extension for 3 to 4 weeks followed by the range of motion exercise on CPM to regain the knee motion and a long-leg brace was provided simultaneously to maintain the correction for 3 months.Secondary osteotomy was performed on anterior bowing deformity of the distal fermur in 8 patients.[Result]More than 30 degrees of severe flexion contracture of knee joint (mean?sd 58.50?21.28?) in 49 patients (52 knees ) were corrected to an average of 4.12?4.61 degrees after treatment.40 joints of 38 cases were followed for an average of 6.8 months,in which 28 joints maintain the postoperative effect.,while 12 joints had partial relapse of 9.30??8.24?.[Conclusion]Ilizarov's technique for correcting severe flexion contracture of the knee joint,can have satisfactory effect with little complications.It is mini-invasive,reliable and safe.

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.

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.

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%.

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.