[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.

Objective To compare the differences between state-owned hospitals and private-funded hospitals in Shanghai on the introduction and application of hospital marketing conception. Methods Questionnaire and interviews were conducted to reflect understandings in marketing conception,advertisements,hospital brand,customers' sense of satisfaction,etc. Results State-owned hospitals were less concerned in marketing conception compared with their private counterparts,even less sufficient in marketing input or management. Conclusion The state-owned hospitals should update their conception and enhance their ability of marketing management.While the private hospitals need to maintain the moderation of marketing and deal with the relationship among marketing,profit and development properly.

Objective To study the relationship between the washout speed in the contrast-enhanced ultrasound (CEUS) and the differentiation grading in pathology in patients with hypervascular hepatocellular carcinoma (HCC).Methods Totally 271 patients who underwent complete resection for hypervascular HCC from April 2009 to December 2014 at Nanchong Central Hospital were included in this study.CEUS examinations were perfomred in all patients 2-3 days before liver resection.A timer on the ultrasound screen displayed the time elapsed since the saline flush was used to determine time to washout.The washout rate were categorized into four levels based on enhancement in portal venous phase and delayed phase.The differentiation grade and the washout speed were compared using Kruskal-Wallis test.Results All 271 (100％) lesions were arterially enhanced with different washout rate.Washout speed 1 was found in 19 patients (7.0％),while speed 2 in 157 patients (57.9％),speed 3 in 65 (24.0％),and speed 4 in 30,respectively.The washout speed had a significant correlation with the differentiation (x2=179.8238,P ＜ 0.001).The faster washout speed,the higher differentiated.Washout speed 1 could distinghuish well-differentiated from the poor and moderately differentiated tumor.The sensitivity and specificity of preoperative washout speed 1 to identify well histologic grade were 98.0％ and 77.8％,the positive predictive value and negative predictive value were 96.0％ and 48.8％,and the positive likelihood ratio and negative likelihood ratiowere were 1.9 and 0.01.Washout speed 4 could distinghuish poor differentiated from well and moderately differentiated tumor The sensitivity and specificity of preoperative washout speed 4 to identify poor histologic grade were 24.3％ and 97.0％,the positive predictive value and the negative predictive value were 65.3％ and 61.3％,and the positive likelihood ratio and negative likelihood ratiowere were 3.2 and 0.7.Conculsions Washout speed can reflect the degree of differentiation roughly.Washout speed can effectively diagnose the well-differentiated HCC,but it is difficult for moderate and poor differentiated HCC.

Objective:To optimize the water extraction process of Lidan Palshi capsules. Methods:The extract yield, emodin con-tent and chrysophanol content were used as the indices, the extraction process of Lidan Palshi capsules was optimized by orthogonal test of L9(34). Results:The optimized water extraction conditions were as follows:adding 14-fold water, and boiling extraction four times with 2 hours for each time. Conclusion:The water extraction process is practicable, reasonable and convenient.

?AIM: To evaluate the clinical effects, corneal surface shape and corneal thickness variation after treated by Danzhi Xiaoyao Capsule combined with hypromellose 2910, dextran 70 and glycerol eye drops for dry eye in menopausal patients.?METHODS: Eighty menopausal patients ( 160 eyes ) diagnosed as dry eye were randomly divided into groups A and B ( 40 patients each ) . Group A was treated with hypromellose 2910,dextran 70 and glycerol eye drops only and group B was treated with Danzhi Xiaoyao Capsule and eye drops. Before and 1mo after treatment, the clinical effects were evaluated by symptom scores, fluorescein staining ( FL ) , tear film breakup time ( BUT ) and Schirmer Ⅰ test. While the corneal surface regularity index (SRI), surface asymmetry index (SAI) and central corneal thickness ( CCT) were observed.? RESULTS: At 1mo after treatment, the symptoms scores and FL scores of the 2 groups decreased significantly( P<0. 05 ); BUT and SⅠt were significantly increased (P<0. 05). SRI and SAI gradually increased with dry eye exacerbations, after treatment the two parameters significantly reduced than those before treatment. SRI of group B improved significantly more than group A. CCT gradually got thinning with the dry eye condition worsened, which also significantly increased after treatment (P<0. 05);but there was no difference between 2 groups before and after treatment(P>0. 05).?CONCLUSION: Combination therapy of Danzhi Xiaoyao Capsule and hypromellose 2910, dextran 70 and glycerol eye drops for menopausal patients with dry eye is more effective than single eye drops, and can improve the symptoms and signs.

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 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.

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 .