Object To determine the baicalin content in skullcap polyploid by MEKC and HPLC, and to provide the reliable method used to determine a large number of samples. Methods On the basis of methodology of MEKC and HPLC, the baicalin in Scutellaria baicalensis Georgi. was determined, the data and relevant analysis were compared. Results The data of the content determined by HPLC was similar to that by MEKC, but the former showed slightly higher 1%-3%. There was no significant variation between the two methods with higher correlation coefficient. Conclusion Both the above two methods could be accurately used to determine the baicalin in S. baicalensis. The MEKC has some advantages, such as quick, save time with lower solvent cost, and is suitable for the large number of samples in the determination of baicalin of S. baicalensis.

Objective Discussion transurethral holmium laser treatment of ureteral orifice cyst and stones efficacy and safety . Methods A retrospective analysis of 23 cases of transurethral holmium laser treatment in patients with ureteral orifice cysts and stones (minimally invasive group) and 11 cases of open surgical excision of the cyst and stone -treated patients (open group), two groups were compared operative time, blood loss , catheterization time, hospital stay, postoperative complication rate .Results Minimally invasive surgery patients time (20.0 ±5.6)min, blood loss (15.0 ±2.3)ml, ambulation time (10.0 ±2.5)h, catheterization time (2.3 ± 0.2)d, length of hospital stay (5.0 ±0.6)d; open group of patients were (90.0 ±10.3)min, (80.0 ±12.7)ml, (48.0 ±5.3)h, (7.0 ±1.1)d, (11.0 ±1.7)d, two groups of indicators differences were statistically significant ( P <0.05).Postoperative complica-tions occurred in patients with minimally invasive group was 8.6%, down from 45.4% in the control group, the difference was statisti-cally significant ( P <0.05).Conclusions Transurethral holmium laser treatment of ureteral orifice cysts and stones with less trau -ma, less bleeding, shorter operative time, rapid recovery, the advantages of the low rate of complications , treatment of ureteral orifice cysts and stones safe and effective method .

ObjectiveTo introduce the indications and operative procedure of anatomic reconstruction of the distal radioulnar ligaments in patients with chronic instability of the distal radioulnar joint(DRUJ),and report its preliminary clinical results.Methods From October 2008 to June 2009,6 patients with instability of the DRUJ underwent anatomical reconstruction using a free palmaris longus tendon graft,including 4 males and 2 females with an average age of 22 years.A 5 cm dorsal incision was made between the fifth and sixth extensor compartments.An L-shaped flap was created in the DRUJ capsule.This flap is then elevated proximally to expose the articular surface of the DRUJ and the proximal triangular fibular cartilage complex(TFCC).A tunnel was made through the radius.The other tunnel was made between the ulnar neck and the fovea of the ulnar head.A whole-length palmaris longus tendon graft was taken.The volar opening of the radius tunnel was exposed through a longitudinal incision radial to the flexor carpi ulnaris tendon.One end of the graft was pulled to the palmar side easily through the tunnel.A hemostat was penetrated through the volar capsule to the volar side proximal to the remaining TFCC.The end of the graft was grasped with the hemostat and pulled back along this tract.Both graft limbs were passed through the ulnar tunnel to exit at the ulnar neck.One limb of the tendon was passed around the ulnar neck and deep to the ECU sheath.With the forearm in neutral rotation,the limbs were pulled taut,tied together,and secured with sutures.Immobilize the extremity in a long-arm plaster splint with the forearm in neutral position for 4 weeks,and changed to a short arm cast for an additional four weeks.ResultsThe average follow-up period for all 6 patients was 14 months(range,9-24).No infection and sensory nerve branch disturbance occurred.The pain symptom was reduced and the grip force was improved significantly.A functional evaluation was performed using the modified Mayo wrist scoring system.All patients had better wrist scores postoperatively in the short (mean,95) term compared to preoperatively(mean,69).Five patients satisfied with the final result.Conclusion Anatomic reconstruction of the distal radioulnar ligaments is indicated for chronic DRUJ instability without osteoarthritis,it is a reliable method with a very good short term follow up result.Restoration of the radioulnar ligaments offers the best possibility to restore the normal DRUJ primary constraints and kinematics.

Objective To evaluate the treatment effects of middle and proximal phalangeal fractures with lateral fixation of mini-titanium plate.Methods From December 2011 to April 2015,56 patients (64 phalanges) suffered from closed middle and proximal phalangeal fractures were treated with lateral fixation of mini-titanium plate.There were 48 males and 8 females,aged from 17 to 65 years (average,36.3 years).Fractures included 25 cases of middle phalangeal fracture and 39 cases of proximal phalangeal fracture.According to site of fracture,12 cases were middle phalangeal condyle fractur,7 cases were middle phalangeal shaft fracture,6 cases were middle phalangeal base fracture,10 cases were proximal phalangeal condyle fracture,22 cases were proximal phalangeaal shaft fracture and 7 cases were proximal phalangeal base fracture.According to the type of fracture,13 cases were transverse,9 cases were short oblique,11 cases were long oblique,6 cases were spiral and 25 cases were comminuted fracture.All phalangeal fractures were exposed by lateral approach,in which the lateral band and oblique fibers of proximal phalanx were excised to fully expose proximal phalangeal fracture.After the reduction,the fractures were fixed with mini-titanium plate laterally.The Disabilities of the Arm,Shoulder and Hand (DASH)and the bilateral fingers total active motion (TAM) were employed to evaluate the functions.All patients took X ray during follow-up.Results All 56 patients were followed up from 9 to 47 months,average (14 ± 6) months.Phalangeal fractures were healed from 7 to 14 weeks,average (8.8 ± 2.4) weeks without loss of fixation or malunion.At final follow-up,DASH score were from 1.7 to 7.5,with an average of 4.8 ± 2.2.TAM of the fingers was excellent (＞ 90％ TAM of the contralateral side) in 33/64 (51.5％) cases,good (75％-90％ TAM of the contralateral side) in 30/64 (46.9％) cas es,fair (50％-75％ TAM of the contralateral side) 1/64 (1.6％) cases.Conclusion Lateral approach fully exposes middle and proximal phalangeal fractures and less interferes with the extensor mechanism.Lateral fixation with mini-titanium plate could provide stability and allow early motion.This technique may be an optional choice in clinical practice.

Objective To evaluate the feasibility,technique and preliminary clinical results of the intraoperative three-dimensional (3-D) computer navigation system assisted free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head.Methods From October 2010 to April 2013,14 patients (18 hips) with osteonecrosis of the femoral head were treated by free vascularized fibular graft transfer,assisted by intraoperative3-D computer navigation system.Of 18 hips,8 were classified as stage Ⅱ ;6 as stage Ⅲ,4 as stage Ⅳ according to Steinberg system.The entire procedures were visualized and guided by the 3-D navigation system,including location of optimal entry point,exploration of the field,excision of the necrotic bone tissues,and the fibular grafting transfer with vessel anastomosis.The follow-up records included the results of X-ray,the Harris score of the hip,and the complications.Results Operations of all 14 patients (18 hips) were smooth and successful with patent vessel and umcompromised grafts evidenced by ECT scan at day 7 postoperatively.Postoperative X-ray confirmed the complete eradication of necrotic focuses with surrounding calcified bone and the accurate positioning of fibular grafts.The mean follow-up period was 23.6 months (8-29 months).Harris scores significantly improved from 57.5 ± 14.5 before operations to 87.5 ±2.5 after,with 6 hips' scores classified as Excellent,and 11 as Good.X-ray obtained more than 1 year after operation suggested improvement was achieved in 15 hips.Conclusion Intraoperative 3-D computer navigation system has multiple merits in assisting free vascularized fibular grafting for the treatment of osteonecrosis of the femoral head,including clear anatomic structure,better accuracy,less damage,and reliable functional recovery,which imply it is a highly applicable approach.

Objective:To evaluate the outcomes of lesser arc perilunate injuries (Perilunate disloca-tions)treated with arthroscopically assisted mini-invasive reduction and fixation.Methods:Between 2012 and 2014,5 patients who had a perilunate dislocation were treated with arthroscopically assisted re-duction and percutaneous fixation.The mean follow-up was 17.8 months (range,10 to 32 months). Clinical outcomes were evaluated on the basis of range of motion;grip strength;Mayo wrist score;Quick disabilities of the arm,shoulder and hand questionnaire;and patient-rated wrist evaluation score.Radio-graphic evaluations included carpal alignments and any development of arthritis.Results:The range of flexion-extension motion of injured wrist averaged 84% of the values for contralateral wrist.The grip strength of the injured wrist averaged 90% of the values for the contralateral wrists.The mean Quick Disabilities of the arm,shoulder and hand score was 1 ,and the mean Patient-Rated Wrist Evaluation score was 5 .According to the Mayo wrist scores,the overall functional outcomes were rated as excellent in all the patients.Reduction obtained during the operation was maintained within normal ranges in all the patients.Arthritis had not developed in any patient at the end of the follow-up.Conclusion:Arthroscopic mini-invasive reduction with percutaneous fixation is a reliable and favorable alternative in the treatment of perilunate dislocations according to our early results.

Objective To study the postmortem distribution of Bromadiolone and its metabolite-Benzylideneacetone in dogs and provide an experimental evidence for the sampling of Bromadiolone poisoning cases. Methods The dogs were given 2LD50 and 4LD50 Bromadiolone by intragastric administration. Anatomy was conducted immediately after death and samples of body fluids and viscera (heart blood; peripheral blood, bile, urine, heart, liver, spleen, lung, kidney, brain, urinary bladder, left leg muscle, stomach, stomach contents, pancreas) were collected and detected after the dogs poisoning death. The Bromadiolon and its metabolite-Benzylideneacetone contents in samples were analyzed by GC/MS. Results Hemorrhagic symptoms came out at 3d after Bromadiolone delivery and deaths occurred at (178.40±20.94)h after intoxication. The postmortem distribution of Bromadiolon and its metabolite-Benzylideneacetone in dogs was as following: 2LD50 Bromadiolon: bile>urine, liver, heart, kidney>heart blood, peripheral blood, spleen, lung and so on. Benzylideneacetone: the content in bile, urine, heart blood, peripheral blood, lung, stomach contents are higher. 4LD50 Bromadiolon: bile, urine>liver, peripheral blood>heart blood, stomach contents and others. Benzylideneacetone:contents in bile, urine and lung are higher. Conclusion The postmortem distribution of Bromadiolon and its metabolite-Benzylideneacetone in dogs is uneven, contents in bile, urine, liver, heart blood and peripheral blood are higher, whichare suggested for forensic toxicological analysis in Bromadiolon poisonig case.

Objective To study the pharmacokinetics and detection window of clozapine and its metabolites in human blood, so as to provide experimental basis for forensic cases of identification of clozapine poisoning. Methods 29 Taiyuan Han people's elbow venous blood was collected after given oral administration of 12.5mg clozapine at different time point, in which clozapine and its metabolites were extracted with solid phase extraction (SPE) and determined by HPLC-MS-MS. The qualitative analysis was based on retention time and MRM ions. The quantitative analysis was based on an internal standard method and calibration curve. Using the 3p97 pharmacokinetic software, pharmacokinetic equation of clozapine in the blood were imitated from the C-T data, and pharmacokinetic parameters were calculated. Results The pharmacokinetics of clozapine met a two compartment open model with a first kinetics absorption. The Tmax of clozapine(CLP), demethylclozapine(DMCLP), N-oxidation-clozapine(NO-CLP) respectively were 2.96±1.32h, 8.65±3.00h, 9.31±26.38h; The Cmax of CLP, DMCLP, NO-CLP respectively were 34.68±9.32ng/mL, 11.16±4.15ng/mL, 9.62±13.88ng/mL;The t1/2 of CLP, DMCLP, NO-CLP respectively were 17.02±23.63h, 27.06±12.58h, 41.27±29.75h; The detection window of CLP, DMCLP, NO-CLP respectively were 81.72±26.19h, 93.21±29.40h and 19.93±14.62h. Conclusion The pharmacokinetics of clozapine in blood of Han people is consistent with two compartment open model with a first kinetics absorption. The pharmacokinetics model and parameters of clozapine can provide expirimental basis for forensic identification of clozapine poisoning cases.

Objective To investigate the clinical efficacy of dry arthroscopy in the treatment of wrist joint injury. Methods A retrospective case series study was conducted to analyze the clinical data of 59 patients with wrist joint injuries admitted from January 2013 to January 2016. There were 48 males and 11 females, aged 15-69 years, with an average age of 34 years. Among the patients, there were 32 patients with old scaphoid fractures ( including delayed diagnosis and treatment of scaphoid fractures or scaphoid fracture nonunion) , 23 patients with intra articular fractures of distal radius, and four patients with chronic instability of lower ulnar radial joint. All patients were treated with dry arthroscopic surgery. During the operation, the operation time of bone grafting and the swelling degree of soft tissue around the joint which needed simultaneous incision were observed. Fracture healing, and joint stability were recorded after operation, and wrist function was evaluated by Mayo wrist function score. Results The average operation time of scaphoid bone grafting was 7 minutes. In patients with distal radius fractures requiring simultaneous incision and reconstruction of the lower ulnar radial ligament, there was no significant periarticular swelling, with normal anatomical layer and clear visual field. All patients were followed up for 6-28 months ( average 9 months) . All the old scaphoid fractures were healed, with the average healing time of 12. 6 weeks. All distal radius fractures were anatomically repositioned during operation. All patients with chronic instability of the lower ulnar radial joint were seen stable recovery of the joint, with negative impact test of the lower ulnar and radial joints. The Mayo wrist function score of all patients averaged 95 points. Conclusion Dry arthroscopic technique can improve the efficiency of bone grafting under wrist arthroscopy, reduce the swelling of soft tissue around the joint, maintain clear anatomical layers of soft tissue, promote fracture healing and improve wrist function, especially applicable for wrist arthroscopy with minimally invasive bone grafting and wrist incision at the same time.

Objective To evaluate conventional wrist physical examination in detecting injury to the triangular fibrocartilage complex (TFCC).Methods A retrospective study was conducted of the 118 patients (119 wrists) who had been admitted from January 2013 to October 2017 to Hand Surgery Department,Beijing Jishuitan Hospital for wrist arthroscopic surgery.All of them underwent wrist physical examination preoperatively for conventional index tests for TFCC injury like ulnar fovea sign,piano-key test,distal ulnar ballottement test and ulnocarpal stress test.They were 68 males and 50 females with a mean age of 32 years.The results of physical examination were compared with the arthroscopic findings to calculate the sensitivity,specificity,positive/negative predictive value (PPV/NPV) and +/-likelihood ratio (LR) of each index test.In addition,we combined the results of any 2 tests to increase the capability of detecting peripheral TFCC injury.Results The diagnostic values of each index test were achieved by comparison between the results of physical examination and the arthroscopic findings:(1) ulnar fovea sign:sensitivity =0.648,specificity =0.742;(2) piano key test:sensitivity =0.817,specificity =0.735;(3) distal ulnar ballottement test:sensitivity =0.927,specificity =0.647;(4) ulnocarpal stress test:sensitivity =0.825,specificity =0.500.The combination of any 2 tests produced 3 new index tests,of which the most valuable combination was ulnar fovea sign & distal ulna ballottement test,with a sensitivity of 0.598,a specificity of 0.941,a PPV of 0.961and a + LR of 10.14,Conclusions The signs elicited in physical examination and special tests can be helpful in the diagnosis of TFCC injuries.However,as the value of any single test is not enough,we should clinically combine the results of ulna fovea sign and distal ulna ballottement test to increase the capability of detecting peripheral TFCC injury.