From previous investigation, it appears that vitamin C content of one variety of vegetable as found in the market may vary considerably. However data on this point are few. Present study investigated the variation of vitamin C content of a number of common vegetables available in the Shanghai market and the influence of different methods of cooking. Harris & Olliver method slightly modified was used to determine the ascorbic acid and dehy-droascorbic acid. Roe, Mills, Osterling & Dainron method was also used to determine the ascorbic acid, dehydroascorbic acid and diketogulonic acid.The results were as fellows:1.Among 26 different vegetables, the vitamin C of each variety taken at different times of the year showed a variation from less than 1 to 5 times. Generally the variation was from 2 to 3 times. Spinach, green peppers, potato, small onion, aster shoots, foreign cabbage, leeks, string beans showed variation of from 3 to 5 times. Majority of the vegetable showed vitamin C content similar to those in Peking, a few showed values twice as high as those in Peking.2.Dehydroascorbic acid was present in all but 2 of the 35 kinds of vegetable tested. The majority showed less than 10% of the total vitamin C. Eight vegetables showed a presence of 10-20%, seven vegetables 21-50%, and only one vegetable over 50%. Among 32 kinds of vegetable studied, the majority showed an absence of dikitogulonic acid, only a i'ew showed a trace of the acid.3. Four different methods of cooking were used. The loss of ascorbic acid during quick frying (used small amount of oil) was 6.2-48.7%, averaging 25.2%. Dehydroascorbic acid and ascorbic acid showed a total loss of from 7.3-46.8%, averaging 23.4%.Boiling of vegetable caused a loss of ascorbic acid of 4.6-50.6%, averaging 16.2%, while the loss of the sum of ascorbic acid and dehydroascorbic acid was 4.6-40.4%, averaging 15.3%.Steaming of vegetable on the whole caused a destruction of vitamin C more than quick frying and quick boiling. The average loss was 31.9% of ascorbic acid and 23.6% of the sum of ascorbic acid and dehydroascorbic acid.Salting of vegetable for one hour caused an average loss of 24,7% of ascorbic acid and an average loss of 18.1% of the sum total of ascorbic acid and dehydroascorbic acid.Standing for one hour after steaming caused an average loss of about 73% of ascorbic acid, while standing for one hour after quick frying caused only a loss of about 13% of ascorbic acid.

The ascorbic acid contents of 48 kinds of wild vegetables, 8 kinds of tree leaves and 6 other plant materials were determined by the 2:0 dichloro-phenol indophenol titration method. Values higher than 100 mg% were Astragalus sinicus L., Lathyrus maritimus Bigel. and sixteen others. Values between 50-100 mg% were Matricaria chamomilla L., Lepidium virginicum L. and sixteen others. In general, wild vegetables and certain tree leaves contain more vitamin C than the usual cultivated plants.Vegetables (wild) and tree leaves collected in July appeared to contain less ascorbic acid than those collected during January to June. Vegetables (wild) grown in sunny places contained more ascorbic acid than those grown in shady ground. Most wild vegetables and tree leaves taken at different times of the year showed great variation (2-3 times) in ascorbic acid contents. Only a few showed little variation.

Curative resection can offer a better chance for long-term survival than any other therapeutic modalities for hilar cholangiocarcinoma.This review highlights recent improvements in hilar cholangiocarcinoma management,with special attention to the new staging system for hilar cholangiocarcinoma,the perioperative management and the accurate dissection approach to achieve more adequate tumor-free resection margin.Overall,the precise surgical strategy and appropriate surgical techniques may provide an increased chance to cure patients with hilar cholangiocarcinoma.

Phototherapeutic keratectomy(PTK)has been employed as a surgical tool to treat corneal disease for about 20 years.PTK made it possible to remove superficial corneal opacities and thereby restore vision by splitting molecules of biological tissue with 193 nm ultraviolet light.Recently,the development of the excimer laser technique is more rapid.It has principally focused on refractive surgery but has also benefited PTK.Anterior corneal pathology,such as elevated lesions,stromal opacities,corneal scars,corneal dystrophies and corneal degenerations etc,can be visually devastating.Over the past decade,there was a shift in the treatment of these conditions from corneal transplantation to PTK for visual restoration.PTK is a powerful tool for the management of anterior corneal pathology.In a properly selected and well-counseled patient,PTK can significantly improve vision and quality of life.This article reviews the recent literature of techniques for performing and refining PTK and also of various pathologic conditions that can be treated with PTK.

Objective To explore enhanced MRI diagnostic value of CPA(cerebellopontine angle) tumors.Methods 68 cases of CPA tumors,including acoustic neuromas(n=34),trigeninal neuromas (n=5),meningiomas(n=20)and cholesteatomas(n=9),proved surgically and pathologically were studied.All patients were performed MR scans before and after contrasted-enhancement on axial,sagittal and coronal plane.Results 23 of 34 acoustic neuromas showed nodule-ring-like,wreathlike or mutilocular enhanced masses;11 were homogeneous masses.The facial-hearing nerve bundle were markedly thickened and enhanced in 34 cases and in which 15 presented "water-chestnut"sign;suggesting it was a typical appearance of acoustic neuromas.5 trigeminal neuromas manifested nodule-ring-like or multilocular enhanced masses(n=3),and dumbbell-like masses(n=2).20 meningiomas exhibited homogeneous massive enhancement,"dural tail"sign(n-11),the facial-hearing-nerve bundle on the affected side were enhanced but not thickened(n-5);which represented reactive changes to the tumors.9 cholesteatomas displayed long T 2 long T 1,no enhancement;spreaded along subarachnoid space and basilar artery encapsuled(n-5).Conclusion Enhanced MRI can reveal the characteristics of CPA tumors,it is of especial value for diagnosis of the tumors.

Micrometastasis is small metastasis at the cellular and molecular level. Early detection of micrometasis through tumor markers can improve the accuracy of TNM staging, prognosis and subsequently treatment for lung cancer patients. Currently, a number of markers with good specificity and sensitivity have been found, including CK19 mRNA, Lunx mRNA, MUC1 mRNA and GPRP mRNA. These markers can be detected using methods such as RT-PCR, immunohistochemistry and western blot.

BACKGROUND: The wound eschars are often excised from the large wounds of deep second degree bum, but the tangential excision may remove excessive tissues of the epithelial regeneration in residual skin wounds.OBJECTIVE: To investigate the therapeutic effect of electro-driven abrasion treatment in deep second-degree bum wounds on keratin 19 expression, the marker of the epithelial stem cell in residual skin wounds.DESIGN, TIME AND SETTING: Randomized controlled trials were performed from October 2002 to January 2004 in the Guangxi Medical University.MATERIALS: Forty patients suffered thermal (heat or fire) burns were recruited from Department of Burn and Plastic Surgery,aged 18-37 years. The average burn size approaches 15% -45% total body surface area, while deep second-degree burn size was 15%-30%. The patients were divided randomly into two groups, abrasion treatment group (n=20) and tangential excision treatment group (n=20).METHODS: Abrasion treatment group: The wound eschers were removed from superficially to deeply by the electro-driven abrasion instrument, until the wound beds were red hyperaemia or bead bleeding. Tangential excision treatment group: The wound eschars were excised by the skin graft knife, until the wound beds were chalkiness and wet. There were not brown tissue and reticular vascular thrombi. The wound beds were bead bleeding after the hemostasia strap was relaxed. At times the operations were so excessively deep as that fat tissues on the wound beds were revealed. The wound beds in two groups were covered by porcine skin postoperation.MAIN OUTCOME MEASURES: Tissue specimens were taken from the wounds to detect keratin 19 expression in regenerative tissues by using S-P immunohistochemical method before and after operation. Assisted by optical microscope (100x), five view areas were randomly selected to count cells. The healing time of the wounds in two groups was recorded, the granulation wounds that failed to heal required secondary operation.RESULTS: Electro-driven abrasion treatment could preserve more skin attachment, such as dermis, hair foltides, sebaceous glands,and sweat glands. Tangential excision treatment could preserve less skin attachment, such as lamina network tissue residuals, some hair follicles and sweat glands. At times the fat tissues on the wound beds were revealed, rather than dermis. Results of cell counts expression, keratin 19 expression in the residual skin wounds could be seen in both two groups before and after operations. No significant difference was found in the keratin 19 expression before and after abrasion treatment (P > 0.05), while keratin 19 expression counts in the tangential excision treatment group were decreased compared with before operation (P < 0.05). The healing in the abrasion treatment group occurred eadier than in the tangential excision treatment (P < 0.05). There were 2 wounds in the abrasion treatment group and 8 wounds in the tangential excision treatment group requiring secondary operation (P < 0.05).CONCLUSION: Applying electro-ddven abrasion treatment to heal deep second-degree burn wounds is efficient and induces less damages to tissues. Compared with tangential excision treatment, it can preserve more regenerated skin tissues, and is helpful to repair of epithelial stem cells through the regeneration and to shorten the healing time of wounds.

Adolescent ; Child ; Humans ; Insulin Resistance ; Metabolic Syndrome ; diagnosis ; prevention & control

Objective To evaluate the short term results of shoulder hemi-arthroplasty. Methods Twenty-one patients with comminuted intra-articular fracture of proximal humerus underwent Neer type (Link, Germany) humeral head replacement from August 2000 to January 2004, which involved 5 males and 16 females,with an average age of 70 years (range, 64-76 years). According to AO M?ller classification, 3 cases were of C1 type, 8 C2 type, and 10 C3 type. The important steps of the procedure included insertion of the prosthesis in 40 degree retroversion and reconstruction of the rotary cuff of shoulder. The rehabilitation training course was divided into three stages. The patients were trained passively in the first stage (1 day-6 weeks); The muscles around the shoulder undertook isometric contraction once the bone fusion of greater and lesser tuberosity were obtained on X-ray for the second stage (7 -12 weeks); The improvement of the muscle strength and ROM of the shoulder were targeted throughout the third stage (13-24 weeks). All cases were followed up with Neer's scoring system comprising the symptoms, function, range of motion (ROM) of shoulder, and position of the prosthesis. Results The follow-up was performed twice a month within one year postoperatively, and one time three months after that.The mean duration of follow-up was 34.5 months (range, 14 to 55 months). Only slight pain was complained occasionally in 4 cases. No difficulty in active daily life was found in 21 cases .The average ROM of shoulder was flexion 115?(range, 65?-165?),extension 42.5?(15?-70?),abduction 85?(50?-120?), adduction 32.5?(20?-45?), external rotation 40?(20?-60?),and internal rotation 50?(10?-90?). No dislocation or subluxation of shoulder occurred in all cases. Assessed by Neer's scoring system, 8 cases were rated as excellent, 9 as good, 3 as fair and 1 as poor. The excellent and good rate was 80.9%. The patients' satisfactory rate was 90%. Conclusion The shoulder hemi-arthroplasty show good short term results for comminuted intra-articular fractures of the proximal humerus. The key points to improve the postoperative results are presented as follows: less invasive technique, appropriate retroversion angle for humeral head prosthesis, very solid reconstruction for rotary cuff of shoulder, and correct consecutive physical therapy after surgery.

Objective To evaluate the medical efficiency of sample hospitals in Sanming city before and after Sanming health care reform.Methods One tertiary hospital,two general county hospitals and two TCM county hospitals in Sanming were sampled for the study.Two dimensions(the intensity index of medical work and work efficiency index)were selected.In addition,six indexes were identified,namely the number of discharged patients,number of outpatients and emergency diagnostics,doctor′s daily workload per capita for inpatients,bed turnover times,bed utilization rate and average days of stay.Descriptive trend analysis and comprehensive index method were applied in turn to evaluate the longitudinal changes in medical efficiency at the sample hospitals before and after the medical reform.Results The five sample hospitals in Sanming were found with less days of stay in average,and three were found with year-by-year rise of medical efficiency index,with one of them rising from 1.57 to 2.42.Conclusions Sanming′s health care reform has effectively improved internal operational efficiency at the sample hospitals,and has well addressed the relationship of medical service efficiency and scale expansion.On the other hand,the relationship between work intensity and medical efficiency needs to be further balanced,resource allocation to be further optimized,and more priority to be put in the development of TCM hospitals.