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 .

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 Study on the stability of carbofuran and its metabolite carbofuran phenol in blood preserved at different conditions,in order to provide a scientific evidence for forensic identification of carbofuran poisoning death. Methods The dogs were given intragastric administration with 4LD50(13.5mg/kg) of carbofuran, the blood were collected and divided into five equally groups preserved at 20℃(NC2.5mg/mL), 20℃(1%NaF), 20℃, 4℃ and -20℃, respectively. The concentrations of carbofuran and carbofuran phenol in above samples were detected by GC-MS/MS with MRM at 0d、5d、7d、15d、40d、83d and 150d. Results The concentration of carbofuran in preserved blood were found to be significant decrease at 7d(P < 0.05), then a steady decline. In each condition, the concentration of carbofuran phenol in preserved blood showed an increasing trend firstly, then a declined tendency. The concentration of carbofuran and carbofuran phenol descending fast in blood at 20 ℃ (NC) and 20 ℃ (1%NaF).Conclusion Carbofuran and carbofuran phenol in preserved specimens are found to be decomposed. The decomposition is quick at 20℃ and slow at -20℃. Citrate sodium and sodium fluoride are not suit for anticoagulation and antiputrefactiva. Biological specimens used for forensic identification of the carbofuran poisoning should be stored at refriferated or freezed, and be analyzed as soon as possible.

Objective To develop a method of support liquid-liquid extraction (SLE) and simultaneous determination of 4 components in somedon and its 8 metabolites by GC–MS/MS. Methods Somedon and its metabolites were extracted by SLE and determined by GC-MS/MS in MRM mode. The qualitative analysis was based on retention time and ratio of ions. The quantitative analysis was based on internal standard method and calibration curve. Results After SLE and determination of 4 components in somedon and its 8 metabolites, the extraction rate were 37.57%~95.87%, the linear range were 0.12μg/mL~16.00μg/mL, the correlation coefficient(r)were 0.989 6~0.999 7, LOD were 0.08ng/mL~14.48ng/mL, the accuracy were 79.63%~122.90%, the interday and intraday precision were 0.99%~7.43% and 2.19%~10.60% respectively. Conclusion Simultaneous determination of somedon and its metabolites by GC–MS/MS in biological samples, which was rapid, simple, accurate and was high precision and recovery, can be used for qualitative and quantitative analysis in forensic cases.

Objective:This study aimed to investigate the functional and aesthetical outcomes after index pollicization for severe congenital thumb hypoplasia.Methods:From June 2010 to November 2018, 26 patients (29 hands) with Manske modified Blauth type ⅢB-V thumb hypoplasia who were admitted to Department of Hand Surgery, Beijing Ji Shui Tan Hospital were treated with index pollicization. Thumb abduction angles, Kapandji score, pinch forces, interphalangeal and metacarpophalangeal ranges of motion were measured. The stability of carpometacarpal joint was checked. Goldfarb function score and Likert scale score were used to evaluate overall function of thumb. Whether new first metacarpal’s physeal closure presence was observed on X-ray film. Postoperative complications were recorded. The patients’guardian’s and follow-up doctor’s subjective satisfactions on thumb appearance and function were surveyed. The correlation between guardian’s satisfaction and objective indicators, the differences between guardian’s and doctor’s satisfactions, the difference between operation satisfaction before and after 3 years old were analyzed.Results:Among 26 patients(4 type ⅢB, 16 type Ⅳ, and 9 type V), there were 19 males and 7 females with an average age of 37 months (range: 15-89 months) during surgery, including 8 left hands, 15 right hands and 3 bilateral hands. The average follow-up was 42 months. Average thumb radial abduction was 46.2°, average palmar abduction was 34.1°, and average Kapandji score was 7.1. Average angle of interphalangeal joint extension was 3.4°, flexion 40.7°, metacarpophalangeal joint extension 4.1°, flexion 38.6°. The average pinching forces (key pinch, tip pinch and tripod pinch) were 0.5 kg, 0.8 kg and 1.2 kg respectively. All carpometacarpal joints were stable. The average Goldfarb score was 4. The average Likert scale was 22. All epiphyses were open. First web contracture and superficial skin necrosis were respectively observed in 1 and 6 cases. There was no correlation between the guardian’s satisfaction and the objective indicators. The guardian’s satisfaction on thumb appearance and function was significantly lower than that of doctors’. There was no significant difference in guardian’s and physician’s satisfaction between patients before and after 3 years old.Conclusions:Satisfactory functional outcomes can be obtained after index pollicization for patients with Manske modified Blauth ⅢB-V thumb hypoplasia, with weak strength of thumb opposition and flexion. The subjective satisfaction of doctors was higher and that of guardians was lower.

Objective:This study aimed to investigate the functional and aesthetical outcomes after index pollicization for severe congenital thumb hypoplasia.Methods:From June 2010 to November 2018, 26 patients (29 hands) with Manske modified Blauth type ⅢB-V thumb hypoplasia who were admitted to Department of Hand Surgery, Beijing Ji Shui Tan Hospital were treated with index pollicization. Thumb abduction angles, Kapandji score, pinch forces, interphalangeal and metacarpophalangeal ranges of motion were measured. The stability of carpometacarpal joint was checked. Goldfarb function score and Likert scale score were used to evaluate overall function of thumb. Whether new first metacarpal’s physeal closure presence was observed on X-ray film. Postoperative complications were recorded. The patients’guardian’s and follow-up doctor’s subjective satisfactions on thumb appearance and function were surveyed. The correlation between guardian’s satisfaction and objective indicators, the differences between guardian’s and doctor’s satisfactions, the difference between operation satisfaction before and after 3 years old were analyzed.Results:Among 26 patients(4 type ⅢB, 16 type Ⅳ, and 9 type V), there were 19 males and 7 females with an average age of 37 months (range: 15-89 months) during surgery, including 8 left hands, 15 right hands and 3 bilateral hands. The average follow-up was 42 months. Average thumb radial abduction was 46.2°, average palmar abduction was 34.1°, and average Kapandji score was 7.1. Average angle of interphalangeal joint extension was 3.4°, flexion 40.7°, metacarpophalangeal joint extension 4.1°, flexion 38.6°. The average pinching forces (key pinch, tip pinch and tripod pinch) were 0.5 kg, 0.8 kg and 1.2 kg respectively. All carpometacarpal joints were stable. The average Goldfarb score was 4. The average Likert scale was 22. All epiphyses were open. First web contracture and superficial skin necrosis were respectively observed in 1 and 6 cases. There was no correlation between the guardian’s satisfaction and the objective indicators. The guardian’s satisfaction on thumb appearance and function was significantly lower than that of doctors’. There was no significant difference in guardian’s and physician’s satisfaction between patients before and after 3 years old.Conclusions:Satisfactory functional outcomes can be obtained after index pollicization for patients with Manske modified Blauth ⅢB-V thumb hypoplasia, with weak strength of thumb opposition and flexion. The subjective satisfaction of doctors was higher and that of guardians was lower.