[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 observe the efficacy of combined Chinese and Western medicines in the treatment of senile functional constipation. Methods: One hundred patients with senile functional constipation were divided into treatment group and control group. There were 50 in each group. The patients in the treatment group were treated with Danggui Shaoyao Decoction and Cisapride Tablets, while the patients in the control group were treated with Cisapride Tablets only. The efficacy in the two groups were compared after three courses. Results: The total effective rate of the treatment group was 92% and the control group's was 78%, the former was higher than latter with the comparatively significant difference (P < 0.05). Conclusion: The results indicate that the combination of Chinese and Western medicines is highly effective in the treatment of senile functional constipation.

As one of the first resident standardized training bases, department of ophthalmology of Shanghai Ruijin Hospital participated in this reform process from 2010. Relevant rules and regulations (training management system , training scheme implementation system and evaluation system ) were strictly obeyed. When new problems emerged, under the guidance of department in charge, a series of regimens were formulated and improved gradually by Ophthalmology Professional Committee of Shanghai Resident Standardized Training Department. Based on reviewing and summarizing the work in the last 3 years, some thoughts and suggestions on the resident standardized training in future were put forward ,in-cluding how to better solve the“heavily used, lightly cultured” problem, the“disregarding medical ethics establishment”problem, the“disregarding assessment of teachers”problem and the“disregard-ing obtaining employment”problem.

Objective To explore the X-ray ,CT and MR manifestations of spinal giant cell tumor(GCT) for improving the diag-nosis level of this rare disease .Methods The X-ray ,CT and MR data in 16 cases of spinal GCT were retrospectively analyzed on the location ,size ,morphology ,margin ,CT density/MR signal intensity and enhancement pattern .Results 4 cases located in cervical vertebra ,8 cases in thoracic vertebra and 4 cases in lumbar vertebra ;in which ,6 cases only involved in vertebral body and other 10 cases involved in vertebral body and and appendix .The lesion affected two neighboring vertebrae in 8 cases ,and affected only one vertebra in the remaining 8 cases .16 cases were protruded into the spinal canals and oppressed the spinal cord .The prominent X-ray and CT images showed eccentric growth ,osteolytic and swelling bone destruction .MR showed isointensity or slight hypointensity on T1WI ,and isointensity or slight hyperintensity on T2WI .After intensified scanning ,the solid portion showed marked inhomoge-neous enhancement .Conclusion Spinal GCT has certain imaging characteristics .CT and MR examination could accurately display the extent of lesion and tumor involvement ,which provides more accurate image information for formulating the strategy of clinical therapy .

The build-in low-pressure monolithic column combined with hydride generation atomic fluorescence spectrometry ( HG-AFS ) was employed for speciation analysis of fish meat. The sample pretreatment and separation approach could be accomplished within 30 min. The proper amount of fish sample was weighed and smashed into puree. The extraction solution composed of 10% HCl, 1% thiourea, and 0. 15% KCl was added before loaded into the automatic temperature controlled vertex system with 2000 r/min. The sample solution was separated through Merck monolithic column, with 3% ( V/V) acetonitrile, 30 mmol/L amonium acetate and 0. 03%(V/V) 2-mercaptoethanol (2-ME) as the eluent. The after-column eluent was digested by novel UV digestion device with pipeline sintered into the lamp, and then detected by hydrid-generation AFS. The rapid LC separation enabled fast mercury speciation of fish sample within 10 min. The different UV lamp digestion effects, eluent components, carrier gas, shield gas, lamp current, as well as PMT working power was optimized. Under the optimal conditions, the robust system achieved detection limits (DL) of 0. 15 μg/L and 0. 14 μg/L for methylmercury and HgⅡ, respectively. The RSD (n=7) was less than 5%, the linear correlation coefficient was 0 . 999 , and the matrix spiked recovery was in the range of 85%-110% for Hg speciation. This method was used for the determination of Hg speciation in fish and soil samples, and was proofed to be a reliable, easy approach for daily inspection.

Objective To analyze the causes of the complications in the treatment of limb deformities with the Ilizarov technique and to discuss the management and prevention of these complications.Methods From January 2000 to October 2010,846 patients with limb deformities (16 upper limbs and 830 lower limbs) who had been treated with Ilizarov technique were retrospectively analyzed,including 508 males and 338 females with an average age of 25.7 years (range,1.2-72).Statistical analysis was used to compare the type,severity,treatment methods and results of complications.Results Postoperative follow-up lasted for 6 to 30 months,with an average of 18 months.There were 81 cases of pin tract infections,36 cases of restricted joint movements,6 cases of skin thermal damage,7 cases of nerves and vessels injury,8 cases of bone delayed union,2 cases of osteofascial compartment syndrome,7 cases of dislocation,5 cases of fixed needle breakage,8 cases of secondary joint deformities,5 cases of serious osteoporosis,6 cases of skin eruption,4 cases of femoral fractures near to proximal external fixator,3 cases of subsequent fracture after external fixator dismantled,11 cases of deformity recurrence and 1 case of the others.Combining with anti-infection,functional training,physiotherapy,and the second operation therapy and so on,a permanent disability was finally left in 13 patients.Conclusion If the Ilizarov technique was used improperly,there would be multiple complications during the preoperative preparation,surgical procedures and postoperative management.Effective preventive measures should be taken,such as following the principle of the Ilizarov technique,standardizing operation procedures,strictly postoperative observation,correcting postoperative rehabilitation exercise guidance,regular follow-up radiography and postoperative adaptability dynamic adjustment of the external technique.

Objective This research is to observe the treatment effects of hip bath and oxygen blowing on severe neonatal diaper rash.Methods 289 neonates with severe diaper rash were randomly divided into three groups.91 cases in the flat tube group,102 cases in the round tube group and 96 cases in the control group.Three groups of neonates were cleaned on the hips and perineuma after poops and then dried with wet tissues and Mupirocin Ointment.The control group was treated with the above-mentioned method.The oxygen blowing groups were treated with hip bath of 1:5000 chameleon solution twice a day.Blowing the hips with oxygen five minutes every time after hip bath.The method of blowing oxygen was that oxygen humidifying containers as normal oxygen aspiration facilities was not filled with water,whose oxygen flowing volume standed at 10 L/min and whose tube blew at the afflicted parts until being dry.The oxygen blower held the oxygen exit and blowed at the afflicted parts in the round tube group and the oxygen blower flattened the oxygen exit and blew at the afflicted parts in the fiat tube group.The treatment effects will be compared among the three groups four days later.Results The cure period of the round tube group was obviously shorter than that of the control group,and the cure period of the fiat tube group was remarkably shorter than that of the round tube group.The total effective rate in the round tube group was obviously higher than that of the control group and the total effective rate in the fiat tube group was obviously higher than that in the round tube group.The difference had a statistical significance.Conclusions The treatment effects for the severe neonatal diaper rash with hip bath and oxygen blowing are remarkable and the oxygen blowing effects with fiat tubes are better than those with round tubes.

Astragalus membranaceus var. mongholicus and Hedysarum polybotrys belong to different genera, but have similar drug efficacy in traditional Chinese medicine theory, and H. polybotrys was used as the legal A. membranaceus var. mongholicus previously. In this study, similarities and differences between them were analyzed via their ITS/ITS2 fragments information. The ITS (internal transcribed spacer) regions were amplified using polymerase chain reaction and then sequenced in two-way. The alignment lengths of ITS regions were 616 bp, in which 508 loci were consistent, and 103 loci were different, accounting for 82.47% and 16.72% of the total ITS nucleotides in length, respectively. As genotype determines phenotype, 1HNMR-based metabolomic approach was further used to reveal the chemical similarities and differences between them. Thirty-four metabolites were identified in the 1H NMR spectra, and twenty-seven metabolites were the common components. Amino acids, carbohydrates and other primary metabolites were similar, while a large difference existed in the flavonoids and astragalosides. This study suggests that A. membranaceus var. mongholicus and H. polybotrys show similarities and differences from molecular and chemical perspectives, which has laid a foundation for elucidating the effective material basis of drug with similar efficacy and resources utilization.

Objective To explore the clinical curative effect of hollow screw internal fixation for the treatment of distal epiphyseal teenagers tibial fracture.Methods Thirty -nine cases of epiphyseal fractures of the distal tibia were treated in Shanghai Children′s Hospital between February 2005 and September 201 4.This study included 24 boys and 1 5 girls with the average age of 1 3.1 years (ranged 1 0.5 to 1 6.2 years old).Preoperative diagnosis was confirmed by the X -ray films or CT examination.All the cases were closed fractures and manipulative reduction all failed.Surgi-cal reduction was performed when plain radiographs showed the fracture gap of epiphysis board and articular surface were greater than 2 mm or after closed reduction.Under C -arm X -ray machine,ankle axial traction was performed initially.Anatomical reduction underwent according to the bone fracture type.The fractures were fixed with cannulated screws by percutaneous or open approach.Postoperative X -ray or CT confirmed anatomical reduction at articular sur-face and growth plate.All patients had been immobilized with short -leg cast for 4 -6 weeks.The ankle joint function and growth were evaluated by means of American Orthopaedic Foot and Ankle Society(AOFAS)Ankle Hindfoot Scale. Results All patients were followed up for 5 to 91 months with an average duration of 35 months.X -ray films showed that all fractures were bone healing.No uneven articular surface was found and there was no extremity rotation and shorte-ning deformity.Results were evaluated by AOFAS scoring system:excellent in 27 cases,good in 10 cases,and general in 2 cases.All patients were able to participate in the normal physical activities.Conclusions CT with multiplanar recon-struction is a premise to make an accurate diagnosis and to choose a reasonable approach.For failed closed reduction for adolescent distal tibial epiphyseal fractures,the cannulated screws are simple and may have a satisfactory effect.

Objective To study the expression of the excision repair cross complementing 1 ( ERCC1 ) and thymidylate synthase ( TS) in gastric cancer and to investigate the correlation between the ERCC 1 and TS ex-pression with the efficacy of FOLFOX adjuvant chemotherapy in gastric cancer patients .Methods A total of 73 gastric cancer patients received modified FOLFOX adjuvant chemotherapy .Real-time PCR was used to investi-gate the expression of ERCC 1 and TS in gastric cancer tissue .We also studied their correlation and association with prognosis .Results ERCC1 and TS expressed in gastric cancer tissues with the positive rate were 42 .5%(31/73)and 61.6%(45/73).There was no significant correlation between the ERCC 1 or TS expression and the clinical features .In this study ,the median of RFS and MST were 16 months and 27 months in patients with ER-CC1-negtive expression,9 months and 16months in patients with ERCC1-positive expression,the median of RFS and MST were significantly different in the two groups (P=0.000,P=0.002).There were no statistical differences on TS expression pattern in either median of RFS or MST (P=0.10,P=0.71).Conclusion The ex-pression of ERCC1 may be useful in prediction of the clinical outcome in gastric cancer patients who treated with FOLFOX7 adjuvant chemotherapy .Patients with ERCC1-negtive expression may benefit from the therapy .