OBJECTIVE:To establish a method for the determination of 4 kinds of residual solvents in racemic ketoisoleucine calcium. METHODS:Headspace gas chromatography was performed on the column of DB-624 capillary column by temperature programmed,detector was FID,inlet temperature was 200 ℃,detector temperature was 250 ℃,carrier gas was nitrogen,flow rate was 1.0 ml/min,injection volume was 1 ml by headspace sampling,equilibrium temperature was 70 ℃ and equilibrium time was 30 min. RESULTS:The linear range was 120.04-480.16 μg/ml for methanol (r=0.997 8),200.21-800.83 μg/ml for ethanol (r=0.998 5),204.05-816.19 μg/ml for ethyl acetate(r=0.999 2),28.35-113.39 μg/ml for tetrahydrofuran(r=0.998 9);detection limits were 6.002 μg/ml,50.05 μg/ml,51.01 μg/ml and 7.087 μg/ml;RSD of precision was lower than 3%;recoveries were 95.0%-105.6%(RSD=3.95%,n=9),97.5%-106.4%(RSD=3.67%,n=9),98.1%-105.9%(RSD=3.16%,n=9)and 88.8%-99.2%(RSD=3.79%,n=9),respectively;4 kinds of residual solvents were not detected. CONCLUSIONS:The method is simple,accu-rate and reliable,and can be used for the determination of residual solvents in racemic ketoisoleucine calcium.

Objective To observe the clinical outcomes of modified posteromedial and posterolateral approaches for the treatment of posterior tibial plateau fractures.Methods Between January 2006 and October 2011,25 patients with posterior tibial plateau fracture were identified.They were 17 men and 8 women,aged from 22 to 76 years (average,46.4 years).According to the AO/OTA classification,there were 4 cases of type 41-B1,6 cases of type 41-B2 and 15 cases of type 41-B3.According to Luo's three-column classification,they were all posterior column fractures.Ten patients with posterolateral tibial plateau fracture were treated by the modified posterolateral approach and the other 15 patients with posteromedial tibial plateau fracture by the modified posteromedial approach.The posterior fractures were fixated with a buttress plate.The knee function was evaluated at the last follow-up by the The Hospital for Special Surgery (HSS) Score.Results All the 25 cases were followed up for a mean time of 13.2 months (from 10 to 24 months).By the radiological Rasmussen criteria for fracture reduction,the mean score immediately after surgery was 16.5 points (from 13 to 18 points),with 20 excellent cases,4 good cases and one fair case.All patients were pain-free with full range of motion.Radiologically,bone union was achieved in all cases after a mean time of 13.9 weeks (from 12 to 18 weeks).No surgery-related complications were found.The mean HSS score was 91 points(range,74 to 97 points) and the good to excellent rate was 100％ (17 excellent and 8 good cases) at the last follow-up.The average range of knee motion ranged from 0° to 125°.Conclusion In the treatment of posterior tibial plateau fractures,because the modified posteromedial and posterolateral approaches can result in excellent fracture reduction under direct visualization and allow for posterior buttress plating,soft tissues can be well preserved and good functional results can be expected.

Objective: To investigate the effects of neferine ( Nef ) on the learning and memory function and the expression of Notch1 and SYN in hippocampus in the rats with chronic cerebral ischemia .Methods:Male SD rats (250-300g) were randomly divid-ed into the sham operation group(Sham), the model group(Mod), nimodipine (Nim) positive control group and Nef treatment group with 5 ones in each .The chronic cerebral ischemia ( CCI ) model was established using bilateral common carotid artery ligation ( 2-VO).The rats were orally administered with NS(5 mg· kg-1),Nim(1 mg· kg -1) and Nef (20 mg· kg-1),respectively for 21 days after the first day of operation .The body weight was recorded .The number of hippocampal neurons in the rats was observed by Nissel staining.The learning and memory function was evaluated by Morris water maze test .Notch1 and SYN protein expressions in hippo-campus were detected by IHC staining and Western blot .Results:Compared with the Mod group , Nef group could reverse the reduc-tion of body weight and the number of hippocampal neurons in hippocampus CA 1 region induced by 2-VO, increase the route and the time of platform finding, prolong the escape latency and decrease the number of platform cross on the 21st day, and the effects were bet-ter than those of Nim (P<0.05).Moreover, the down-regulated SYN and Notch1 protein expressions in CCI group were both increase after the Nef treatment on the 21st day.Conclusion:Nef has a protective effect on the function of learning and memory in CCI rats in-duced by 2-VO,which may be related with the strengthened Notch 1 pathway in CA1 region of hippocampus and synaptic plasticity .

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Objective To investigate the effect of nerve growth factor (NGF) on the bone induction of recombinant human bone morphogenetic protein-2 (rhBMP-2) through local application of NGF in the osteoinductive process of BMP. Methods Thirty-six ICR mice were divided into the experimental group and control group at random, and rhBMP-2/collagen composite was implanted into the right thigh muscle pouch of each group. NGF or vehicle was daily injected into the implanted sites of BMP, respectively, for 7 days starting from the third day after surgery. At d10, d20 and d30 after implantation, new bone formation was measured radiographically, biochemically and histologically to compare the osteogenetic capacity of the two groups. Results In both groups, new bone formation was found at d10. However, there was significantly more new bone in the experimental group according to histological and radiographic examinations. At d10 and d20, alkaline phosphatase activity of the local tissue in the experimental group was significantly greater than that in the control group, and calcium and phosphonium contents of samples were also greater in the experimental group. Arrangement of collagen fibers became more regular in the experimental group than that in the control group. Conclusion NGF possesses synergistic effect on ectopic bone formation induced by rhBMP-2.

Objective To investigate the changes in auditory evoked potential index (AEPI) during endotracheal intubation and the effects of intravenous lidocaine or topical anesthesia of larynx and vocal cords with tetracaine on intubation response. Methods Thirty-six patients classified as ASA physical status and Mallampati intubation status I or II , aged 19-55 yr scheduled for elective surgery under general anesthesia were randomly divided into 3 groups with 12 patients in each group: (1) control group (C) ; (2) intravenous lidocaine group (L) and (3) topical tetracaine group (T). The patients were premedicated with intramuscular atropine 0.01 mg?kg-1 and phenobarbital 0.1 g. Anesthesia was induced with midazolam 30 ?g ? kg-1, fentanyl 3 ?g ? kg-1 and propofol 1.5-2.0 mg?kg-1 . Direct vision tracheal intubation was performed at 3 min after vecuronium 0.1 mg?kg-1 . In group L 1 % lidocaine 1 mg ? kg-1 was given i. v. after propofol injection. In group T the suproglottic area and vocal cords were sprayed with 1% tetracaine 3-5 ml before intubation. All intubations were performed by the same anesthesiologist. BP, HR, SpO2 and AAI value were recorded 1 min before and 1 min after intubation. The time between vecuronium injection and tracheal intubation was also recorded.Results AAI value, MAP and HR significantly increased after endotracheal intubation in all 3 groups. The increase in AAI value in group T was significantly larger than that in group C and L. The increase in MAP and HR in group L after intubation was significantly smaller in group L than in group C and T. There was no significant difference in MAP and HR between group C and T after intubation. Conclusion AAI is more sensitive than MAP and HR in terms of detecting the increase in AAI value induced by responses to tracheal intubation. Neither intravenous lidocaine nor tetracaine topical anesthesia of vocal cords inhibits the intubation. Intravenous lidocaine can attenuate the cardiovascular response to intubation.

Iretreatment with tea polyphenol (TP) at a dose of 10mg/kg ip to rats five days before isoproterenol (ISO) challenge (1mg/kg sc, for two days), resulted in decreases of malonydialdehyde concentration, creatine phosphokinase, lactic dehydrogenase (LDH) and LDH1,activities; increased LDH2/LDH1 ratio and inhibited the extent of myocardial injury, similar to the action of propranol. At the same time TP decreased rat plasma renin activity.The results suggested that the mechanism by which TP protects heart from ISO-induced myocardial injury is due to its antioxygen free radical and inhibition of renin activities.

Objective To observe the effect of cluster needling at scalp acupoints plus paraffin therapy on motor function in cerebral palsy patients.Method Forty eligible patients with spastic cerebral palsy were randomized into a control group and an experimental group, 20 cases in each group. The control group was intervened by cluster needling with long-time retaining of the needles plus Uyeda's approach and conventional rehabilitation trainings specifically for spastic cerebral palsy; the experimental group was intervened by paraffin therapy in addition to the treatment given to the control group. The interventions were conducted once a day, for a total of 8 weeks. The Gross Motor Function Measure-88 (GMFM-88) and Modified Ashworth Scale (MAS) were adopted to evaluate the motor function before and after the treatment.Result The GMFM-88 scores were significantly changed after the treatment in both groups (P<0.05), and there was a significant difference in comparing the GMFM-88 score between the two groups after the intervention (P<0.05). The MAS score was significantly changed after the intervention in the experimental group (P<0.05), while the score wasn't significantly changed in the control group (P>0.05); there was a significant difference in comparing the MAS score between the two groups after the intervention (P<0.05).Conclusion On the basis of conventional rehabilitation trainings, cluster needling at scalp acupoints plus paraffin therapy can produce a significant efficacy in improving the muscular tension and motor function, and benefit the development of cerebral palsy patients.

Objectives:To test the effect of continuous care on rural hypertension control , we developed a com-prehensive intervention strategy and implemented a community-based quasi-experiment in Southwestern rural China.Methods:The intervention took place in Qianjiang District , Chongqing Municipality from July 2012 to June 2014.4 towns were randomly selected and categorized into 2 groups based on a comprehensive consideration of population and social development level.All the rural hypertension patients in treatment group were intervened with the Multi-institu-tional Continuous Pathway which was consisted of three parts:the Continuous Primary-Care Pathway , the Continuous Clinical Pathway and the Continuous Management Pathway.The patients in the control group served as a blank com-parison using the usual care.Difference-in-differences Model was used to test the effect of blood pressure control in treatment group.Results:853 patients were sampled and investigated using the stratified randomly sampling strategy and 712 of them had been followed up by the end of this program.The potential bias of pilot and patient selection were eliminated through control before and after the intervention.The previous blood pressure trends showed no statis-tically significant difference between groups.The systolic blood pressure in treatment group declined by 10.156 mm-Hg ( P<0.001 ) compared to control group after intervention , and the blood pressure control rate had increased by 27.6% ( P<0.001 ).Other contributing factors besides intervention were family structure , education level and med-ical service availability.Conclusion:The continuous care pathway have a significant marginal positive effect on hyper -tension control besides the national compulsory primary care , and the control rate change of blood pressure is more sen-sitive compared to blood pressure change.The potential contributing factors show that other intervention strategies could be developed to improve the rural hypertension control by adding to the social capital of rural patient , reinforcing the health education and facilitating the village transportation.

This paper summarized training status of the Master of Nursing Specialist (MNS) at home and abroad,described and analyzed the cultivation program at home and abroad,and discussed the problems about cultivation objective, enrollment, course system, specialty orientation, clinical training model, teaching method, connotation of practical ability, teachers strength, evaluation and assessment in cultivation of MNS in China. Then MNS training program is proposedso as to provide references for the future cultivation program of MNS in China.