Objective To observe the clinical efficacy and safety ofZhilou Lotion combined with modified Sihuang Ointment in treatment of anal cryptitis.MethodsOne hundred patients with anal cryptitis were randomly divided into observation group and control group, with 50 cases in each group. The control group was given propylene dispersible tablets oral and topicalHuazhi embolism. The observation group received steaming and hip bath with Zhilou Lotion combined with modifiedSihuang Ointment topical external application treatment, 7 days as a course of treatment and 2 courses successive. The TCM syndrome scores of two groups were compared before and after treatment to evaluate the clinical efficacy. The remission time of symptoms, hospitalization time, recurrence rate in 6 months and adverse reactions were observed.Results After treatment, the TCM syndrome scores of two groups were improved (P<0.01), and the scores in the observation group was lower than those in the control group (P<0.01). The total effective rate was 96.0% (48/50) in the observation group, and 80.0% (40/50) in the control group, with statistical significance (P<0.01). The remission time of anal edema, anal dampness, anal pain and anal fall-swell in observation group was obviously shorter than that in the control group, with statistical significance (P<0.01). The average hospitalization time was (15.25±2.78) days in the observation group and (18.46±3.41) days in the control group, the difference was significant (P<0.01). In the observation group, the recurrence rate was 0, 0 and 2.0% in 2, 4, 6 months follow-up, while that was 4.0%, 12.0% and 16.0% in the control group, respectively. The recurrence rates of the control group in 4 months and 6 months were higher than those of the observation group (P<0.05). No significant adverse reactions occurred in the two groups.Conclusion Zhilou Lotion combined with modifiedSihuang Ointment has good clinical efficacy in treatment of anal cryptitis, with low recurrence rate and high safety.

The common problems for non-special pediatric medical practitioners in the depart-ment of hematology include short-time of rotation, weak foundation of pediatric hematology and low enthusiasm of learning. The entrance education was highlighted in order to make refreshers familiar-ize with the severity of illness and eliminate the medical error. Basic theoretical study was strength-ened aiming at improving clinical skill and enhancing the learning interesting. Method of doctor-patient communication was reformed to reduce medical disputes.

Objective: To compile and evaluate the Chinese version of perioperative nursing quality assessment scale, detect and verify the reliability and validity of evaluation scale, and establish a scientiifc evaluation system. Methods: We applied Tuija Leinonene and Helena Leino-kilpi scales as the theoretical framework, and established perioperative nursing quality assessment scale by translation, language study, and expert consultation. hTe questionnaire survey population was 276 patients who had surgery and 200 nurses working in the operating rooms at the 3 Affliated Hospitals of Central South University. hTe scale was tested validity and reliability. Results: Perioperative nurse quality evaluation scale consisted of 32 items and 7 dimensions, including body care, receive information, support, respect, medical staff characteristics, environment and nursing process. The test-retest reliability of scale was 0.977 for patients and 0.997 for nurses. hTe split half reliability of scale was 0.761 for patients and 0.887 for nurses. hTe Cronbach's α of total scale for the patients was 0.918, and the Cronbach's α of factors was 0.658-0.838. hTe Cronbach's α of total scale for the nurses was 0.932, and the Cronbach's α of factors was 0.650-0.836. hTe correlation coeffcient of scale for the patients was 0.363-0.603; the factors and the total correlation coeffcient was 0.535-0.788. hTe correlation coeffcient of scale for the nurses was 0.410-0.700; the factors and the total correlation coeffcient was 0.743-0.902. Conclusion: The Chinese version of the perioperative nursing quality assessment scale is a measurement instrument with a high level of validity and reliability for Chinese society and can be used to determine the quality of perioperative nursing care in our country.

Objective To explore the imaging features of bone marrow edema(BME)and soft tissue edema(STE)caused by bone tumors and tumor-like lesions.Methods Ninety nine patients with bone tumors and tumor-like lesions which were proved by surgical pathology were reviewed.The patients were divided into benign and malignant groups.Evaluation parameters included the size and signal intensity of BME and STE,the features of enhancement,the bone sclerosis and its relation with BME,and joint effusion,et al.The data of two groups were analyzed by X2 test.Results There were 40 patients in benign group and 59 patients belonged to malignant group.BME and STE demonstrated low signal on T1-weighted images and high signal on fat-suppressed T2-weighted images.Some BMEs demonstrated low signal on T2weighted images,which corresponded to sclerosis on X-ray film and(or)CT.Both BME and STE demonstrated uniform enhancement.There were statistically significant differences between benign and malignant groups including the frequency of BME.sclerosis.the median of the size of the BME and STE (P<0.05),which were 57.5%(23/40),25.0%(10/40),2.7 cm,1.3 cm,and 32.2%(19/59).3.4%(2/59),1.6 cm,1.7 cm respectively.No significant differences between the frequency of STE,joint effusion in 2 groups(P>0.05).Conclusions Both benign bone tumors and tumor-like lesions and malignant bone tumors can be accompanied by BME and STE.The size of BME in the benign bone tumors and tumor-like lesions is bigger than those in malignant ones,and the size of STE in malignant bone tumors is bigger than benign ones.

Objective: To establish a method for the determination of curcumine and berberine hydrochloride in Shangke Dieda paste. Methods:An HPLC method was adopted to determine the content of curcumine and berberine hydrochloride in Shangke Dieda paste. For curcumine, the column was InertSutain C18 (250 mm × 4. 6 mm,5 μm); the mobile phase was acetonitrile and 4% acetic acid solution (44 ∶56);the flow rate was 1. 0 ml·min-1;the column temperature was 25℃;the detection wavelength was 430 nm;the sample size was 10μl. For berberine hydrochloride, the column was InertSutain C18 (250 mm × 4. 6 mm,5μm);the mobile phase consisted of acetonitrile-0. 1% phosphoric acid (44 ∶56, 0. 2 g dodecyl sodium sulfate was added to 100 ml solution); the flow rate was 1. 0 ml·min-1;the column temperature was 25℃ ;the detection wavelength was 345 nm;the sample size was 10 μl. Results:A good linear correlation was obtained within the range of 0.01-0.50 μg (r =0.999 3) for curcumin and 0.02-0.16 μg(r =0. 999 9) for berberine hydrochloride. The average recovery was 101. 03% with RSD of 1. 75% for curcumin and 99. 20% with RSD of 0. 64% for berberine hydrochloride (n=9). Conclusion:The established method is simple, accurate, sensitive and specific, which can be used for the quality control of Shangke Dieda paste.

The present residents training for ultrasound departments depends mostly on poorlyscheduled rotation and clinical clerkship,with repeated and obsolete subjects in their training.The authors identified these setbacks and such characteristics as complication of ultrasound medicine,complex and variable ultrasonic scan technique,and the high threshold for beginners.In view of this,the authors adopted the tutorial system training mode for cultivating the residents in their medical care,teaching,research and foreign language competencies.A questionnaire survey of 44 residents so trained evaluated outcomes of the mode,with constructive suggestions raised on expansion of the training base,improvement of teachers’competency and reduction of trainees' workload.

Objective To investigate the incidence,sonographic appearance of the anatomic variation of carpal tunnel median nerve and its accompanying structures in healthy volunteers and explore the value of this variation in carpal tunnel syndrome.Methods A total of 360 hands of 180 healthy volunteers were included in the study.The full course of the median nerve in the forearm and carpal tunnel was examined with high-frequency ultrasound.The median nerve was first located in cross section at wrist and then with continuous cross-sectional scanning to observe the the full course of the median nerve in the forearm and carpal tunnel with high-frequency ultrasound.Results Anatomic variation of carpal tunnel median nerve and its accompanying structures were observed:① High division median nerve were found in 2 wrists (0.56 ％) ;②Bifid median nerve were found in 17 wrists (4.72％) ;③Persistent median artery were found in 22 wrists (6.11％),and 2 wrists (0.56％) were also found accompanied vein.Aanatomic variation of carpal tunnel median nerve accompanied with persistent median artery were observed in 16 wrists (4.44 ％).Conclusions High-frequency ultrasound was sensitive to diagnose the anatomic variation of carpal tunnel median nerve and its accompanying structures.Recognition of these variations can help us to make correct diagnosis of carpal tunnel syndrome.

Objective To evaluate the treatment of current status and prognosis in childhood APL with APL2008 ,which was administrated since 2008 in our center .Methods A total of 43 children with newly diagnosed APL between 2008 to 2014 were studied retrospectively .Treatment options and current status were summarized from 28 patients who received APL2008 therapy . Results Studied 43 patients were at median age of 8 years and 4 months ,with 28 boys and 15 girls .The main clinical manifestations were infection ,anemia ,bleeding ,fever ,hepatomegaly ,splenomegaly and lymphadenopathy .The proportions of low ,intermediate and high risk groups were 27 .9% ,48 .8% and 23 .3% ,respectively .Eleven cases could be diagnosed as DIC .Bone marrow morphology showed abnormal elevation of promyelocyte .37 patients had distinctive immunophenotype such as frequent expression of CD33 , CD117 and MPO .PML/RARαfusion gene positive rate was 100% in 43 children and cytogenetic analysis were positive in 37 cases , of which specific genetic lesion in APL cells with t (15 ;17)(q22 ;q12) was found in 28 cases ,and karyotypes was found in 9 cases as infrequent chromosomal abnormalities .In 43 patients ,4 cases were early dead from intracranial hemorrhage at early stage ,and 11 cases were given up early .There were only 2 cases dead ,2 cases relapsed and 1 case lost among 28 APL children ,which enabled ef‐ficacy analysis possible .96 .4% of these 28 cases achieved HCR .The 2 year Kaplan Meier estimates of OS and EFS were 85 .9% ± 7 .6% and 80 .4% ± 8 .8% .But OS and EFS would be 94 .7% ± 5 .1% and 88 .9% ± 7 .4% if 3 patients who had non standard treat‐ment were excluded .Conclusion Childhood APL were characterized by anemia ,bleeding ,fever and infiltration .APL′s coincidence rate between PML/RARa fusion gene and morphology ,immunology and cytogenetics were 95 .3% ,90 .2% and 86 .5% ,respective‐ly .APL2008 significantly improved the prognosis of APL .

Objective To study inhibitory effect of serine protease activity by Ulinastatin in vitro .Methods Different chromogenic peptides were designed and synthesized.Highly sensitive fluorescence detection was performed to optimize the concentration of each serine proteases and their chromogenic substrates.Multi-point method was used for the calculation of half maximal inhibitory concentration of Ulinastatin .ResuIts Ulinastain could inhibit Polymorphonuclear leukocyte elastase ( PMNE ) and plasmin with IC50 lower than 100 U/mL.For factor Xa, and Kallikrein, the IC50 of Ulinastatin was higher than 1000U/mL.No thrombin IC50 could be calculated at the present experiments.ConcIusion Similar to Ulinastatin injection from Japan, domestic Ulinastatin shows the strongest inhibitory effects on PMNE among those serine proteases.As important references, this study gives reliable data for dose range of domestic Ulinastatin in anti-inflammation, coagulation/anti-coagulation and anti-shock therapy.

Objective To explore the application value of single-door laminoplasty via Y type nano-bone plate in treating multilevel cervical spondylotic myelopathy (MCSM) and analyze the short-term efficacy.Methods From January 2013 to December 2016,79 cases of MCSM were treated with single-door laminoplasty via Y type nano-bone plate to evaluate the improvement of post-operative neurological function by the Japanese Orthopaedic Association (JOA) evaluation system.We also measured cervical curvature of cervical X-ray and C5 sagittal diameter of the spinal canal before operation and 6 months after operation to understand the maintenance and enlargement of the spinal canal.The improvement degree of spinal cord compression was evaluated by preoperative and postoperative cervical MRI.Osseous healing on the open door side and the door shaft side was observed with the aid of three-dimensional spiral CT.Results Follow-up ranged from 6 to 36 months,with an average of (20.4±7.9)months.Preoperative JOA score was (8.6 ± 1.3) points and JOA score 6 months after operation was (14.3 ± 1.5)points (P ＜ 0.05).JOA improvement rate was (68.6 ± 15.8)％;postoperative follow-up X-ray and threedimensional spiral CT showed that the spinal canal had satisfying enlargement,the door shaft side all had osseous healing,the open door side osseous healing was not obvious,and there was no lamina collapse or reclosing.Sagittal diameter of theC spinal canal was (8.9±l.1)mm before operation and (15.1±l.1)mm 6 months after operation (P＜0.05).The spinal canal enlargement rate was (70.8±22.3)％,cervical curvature was (14.8± 7.0)°preoperatively and (15.1±6.7)°postoperatively with no significant difference (P＞0.05).Conclusion EOLP via Y type nano-bone plate is safe and efficacious in treating MCSM.It not only provides a good immediate fixation,but also provides the possibility for the open door side lateral osseous fusion.