Objective: To establish a HPLC-MS method to simultaneously determine the contents of gentiopicroside, liquiritin, rosmarinic acid and harpagoside in Fuzhengpingxiao capsule. Methods The chromatographic separation was performed on a Agilent Eclipse plus C18 column (250 mm × 4.6 mm, 5 μm) with a mobile phase of acetonitrile (A)-0.1% methanoic acid (B) (0-30 min, 15% A-40% A), eluted at a flow rate of 1.0 ml/min and with a split ratio of 3: 1. Negative ionization and selected ion monitoring (SIM) mode on Mass were selected. Results The limit of quantitation (LOQ) values of gentiopicroside, liquiritin, rosmarinic acid and harpagoside were 5.73, 6.37, 6.50, and 6.46 ng/ml, and the limit of detection (LOD) values were 0.46, 0.32, 0. 33 and 0.32 ng/ml, respectively. Good linearity (r > 0.999 0) was obtained over the investigated concentration ranges. Reproducibility was evaluated by intra- and inter-day assays, and RSD values were below 2%. The average recoveries of the 4 compounds were within the range of 98%-102%. Conclusion We have established a rapid and efficient HPLC-MS method for determination of 4 constituents in Fuzheng pingxiao capsule: gentiopicroside, liquiritin, rosmarinic acid and harpagoside.

Objective: To simultaneously determine the contents of five components (amygdalin, paeoniflorin, peimine, astragaloside IV and rutaecarpine) in Fuzheng Pingxiao Capsula by LC-MS. Methods: Chromatographic separation was achieved with gradient elution by Agilent Eclipse plus C18 column (250 mm x 4.6 mm, 5 μm) and an Agilent 1100 Mass Spectrometer system was operated under the SIM mode with electrospray positive ionization (ESI). The mobile phase is acetonitrile-0.1% methanoic acid. Results: The LOQ of amygdalin, paeoniflorin, peimine, astragaloside IV, and rutaecarpine in Fuzheng Pingxiao Capsula were 12.9, 32.2, 1.00, 1.21, and 0.40 ng/mL, and the LOD were 6.46, 6.44, 0.25, 0.61, and 0.16 ng/mL, respectively. Within the linear range, r > 0.999 0. Both intra-day and inter-day precision with RSD was less than 2%. The average recovery rates of the five components were in the range of 98%-102%. Conclusion: This method is fast, sensitive, and reproducible. It could be used to determine amygdalin, paeoniflorin, peimine, astragaloside IV, and rutaecarpine in Fuzheng Pingxiao Capsula under the same chromatogram condition.

This article analyzes and summaries the problems and difficulties existing in the first-aid medicine's clinical teaching.Combined with his own teaching experience,the author has made some exploration on the teaching time,the way of teaching and inspection form,which has got a good teaching effect.It provids the reference and development for the clinical teaching of first-aid medicine.

Objective To investigate early changes of angiopoietin-2(Ang-2)in multiple trauma patients and assess its clinical significance.Methods Forty-five multiple trauma patients aged 2060 years admitted to the hospital within one hour after injury were randomly divided into three groups according to injury severity score(ISS).Blood specimens were obtained immediately upon arrival in the emergency department and plasma samples were assayed for comparing changes of Ang-2,TNF-a and IL-6.Meanwhile,plasma level of Ang-2 was measured and analyzed under different oxygenation index,shock index and base deficit.Results Plasma level of Ang-2 was positively correlated with ISS(P ＜ 0.01)and was concordant with the plasma levels of TNF-a and IL-6(P＜0.01).Furthermore,plasma level of Ang-2 was elevated upon increase of shock index or decrease of oxygenation index(P ＜ 0.01).Plasma level of Ang-2 was elevated with the increase of base deficit(P ＜ 0.01).Conclusions High level of Ang-2 is a marker of endothelial activation and dysfunction early after trauma.Ang-2 is related tightly with the injury severity,inflammation factors,systemic oxygenation and tissue hypoperfusion and may have a tight relation with pathophysiological development and clinical outcome after trauma.

BACKGROUNDSymbrachydactyly is defined as a combination of short fingers with syndactyly. There are few published reports estimating the incidence of symbrachydactyly. The aim of this study was to investigate the clinical features and the outcome of surgical treatment for congenital symbrachydactyly.

METHODSOne hundred and twenty webs of thirty-four patients of symbrachydactyly were involved in the study. The sex ratio was 21 males/13 females. The age ranged from 1 year to 8 years, average 2.6 years. Four cases had both hands involved and 30 patients had one hand involvement. Release of the syndactylous digits webs were completed by one surgical procedure in 14 cases and more than one surgical procedure in 20 cases; 3 to 6 months between the procedures. In the meantime, some of the associated hand deformities were treated.

RESULTSPostoperative follow-up time was 10 to 18 months, average 12 months. All the fingers involved in this study were separated successfully. However, 6 fingers had scar tissue contracture and 8 had web scar adhesion. All complications needed further surgical treatment. Parents of 94.1% of the patients were satisfied with the overall function of the hand, and 76.5% were satisfied with the cosmetic appearance of hand.

CONCLUSIONSThe combination of syndactyly and brachydactyly is the main clinical feature in symbrachydactyly. Separation of the digital webs can greatly improve the function of the hand. However, more work needs to be done to improve the cosmetic appearance of the hand.

Abnormalities, Multiple ; Brachydactyly ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Syndactyly ; surgery ; Treatment Outcome

The aim of this study was to evaluate and compare the colour stabilities of three types of orthodontic clear aligners exposed to staining agents in vitro. Sixty clear orthodontic aligners produced by three manufacturers (Invisalign, Angelalign, and Smartee) were immersed in three staining solutions (coffee, black tea, and red wine) and one control solution (distilled water). After 12-h and 7-day immersions, the aligners were washed in an ultrasonic cleaner and measured with a colourimeter. The colour changes (ΔE*) were calculated on the basis of the Commission Internationale de I’Eclairage L*a*b*colour system (CIE L*a*b*), and the results were then converted into National Bureau of Standards (NBS) units. Fourier transformation infrared (FT-IR) spectroscopy and scanning electron microscopy (SEM) were conducted to observe the molecular and morphologic alterations to the aligner surfaces, respectively. The three types of aligners exhibited slight colour changes after 12 h of staining, with the exception of the Invisalign aligners stained with coffee. The Invisalign aligners exhibited significantly higherΔE*values (ranging from 0.30 to 27.81) than those of the Angelalign and Smartee aligners (ΔE*values ranging from 0.33 to 1.89 and 0.32 to 1.61, respectively, Po0.05). FT-IR analysis confirmed that the polymer-based structure of aligners did not exhibit significant chemical differences before and after the immersions. The SEM results revealed different surface alterations to the three types of aligner materials after the 7-day staining. The three types of aesthetic orthodontic appliances exhibited colour stability after the 12-h immersion, with the exception of the Invisalign aligners stained by coffee. The Invisalign aligners were more prone than the Angelalign and Smartee aligners to pigmentation. Aligner materials may be improved by considering aesthetic colour stability properties.

Objective To investigate the infection following the lymphocytes deleted agent (ATG) and IL-2 receptor antagonists (Basilixinab and Daclizumab)-based induction therapy after renal trausplantation.Methods A retrospective analysis was carried out on 701 kidney transplant recipients between Jan. 1,2005 to Dec.31,2010.According to exclusive and inclusive criteria,finally 549 patients were evaluated,including 429 patients treated with ATG (ATG group) and 120 patients with anti-CD25 monoclonal antibodies (monoclonal antibodies group; 86 patients with Basiliximab,and 34 patients with Daclizumab).The incidence of acute rejection,infection rate,infection time,hospital stay,severe infection rate and mortality were analyzed.After operation,the patients received an immunosuppression therapy including Tacrolimus (cyclosporine A),Mycophenolate-Mofetil and prednisone to present rejection. Part of the patients were treated with ganciclovir and sulfamethoxazole sulfadiazine and trimethoprim for infection prevention.Results The acute rejection rate in ATG group and monoclonal antibodies group was 15.9％ (68/429) and 10.0％ (12/120),and there was no statistically significant difference (P＞0.05).The infection rate in ATG group was 11.9％ (51/429),including 13.7％ (7/51) with severe infection,and mortality was 7.8％(4/51).The infection rate was 15.0％ (18/120) in monoclonal antibodies group,including 11.1％ (2/18) with severe infection,and mortality was 5.6％ (1/18).There was no statistically significnat difference in infection rate,severe infection rate and mortality between two groups (P＞0.05).The hospital stay in ATG group and monoclonal antibodies group was 25.8 days and 19.1 days respectively (P＜0.05).Dead cases had not received regular anti-infection treatment,and the patients age was over 50 years.Conclusion The infection risk and mortality between these two induction therapies are identical,but hn comparison to the patients using ATG,the infection of patients using anti-CD25 monoclonal antibodies is easier to control.Anti-infection prophylaxis is important to reduce infection rate and decrease infectious mortality.

Objective To investigate the incidence of infection and the effect of anti-infection prophylaxis in renal transplanted patients after Basiliximab induction therapy. Methods A total of 204patients who have received renal transplantation and Basiliximab induction therapy from January 1,2001 to December 31, 2010 in our hospital have been retrospective analysed in this study. These patients were divided into a prophylaxis group (118 cases) with Ganciclovir + Sulfadiazine +Trimethoprim therapy and a control group (86 cases) without any anti-infection prophylaxis.Furthermore, 440 transplanted patients in the same peroid without any induction therapy were also analysed. They were also devided into two groups: an anti-infection prophylaxis group (206 cases)and a control group (234 cases) without any anti-infection prophylaxis. Results In the prophylaxis group with Basiliximab induction therapy, there were 23 patients (19. 5 %, 23/118)experienced hospitalization due to infection, 3 cases (13. 0 %,3/23) among them were severe infection, and 3patients (13.0 %, 3/23) died from vital infection. In the non-prophylaxis control group with Basiliximab induction therapy, 27 patients (31.4 %, 27/86) had infection complication, 7 patients (25.9 % ,7/27) among them were severe infection, and 4 patients(14. 8 % ,4/27)died. The incidence of infection between the above two groups is significantly different (P＜0. 05). In the prophylaxis group without induction therapy, the incidence of infection was 15.0 % (31/206), there were no severe infection cases but 7 patients (22. 6 %, 7/31) died from infection. In the non-prophylaxis control group without induction therapy, the incidence of infection was 12. 8 % (30/234), 3 cases among them were severe infection(10. 0 %,3/30)and 5 patients died from infection (16. 7 %, 5/30).The incidence of infection in Basiliximab induced patients without anti-infection prophylaxis is significantly higher than that in patients without induction therapy and anti-infection prophylaxis (31.4 % vs. 12.8 %,P＜0.01). Conclusion Basiliximab induction therapy increased the risk of infection, but not the rate of mortality. It is necessary to give anti-infection prophylaxis in renal transplanted patients with Basiliximab induction therapy.

OBJECTIVE To observe the submucosal infiltrating extent of laryngeal carcinoma tissue by different location,different T staging and external appearance and to analyze the impact of laryngeal carcinoma submucosal infiltrating extent on surgical margin.METHODS Forty-three laryngeal en bloc specimens coming from 43 cases with laryngeal carcinoma were vertically cut-down along tumor long axis,and were slivered into sections by which laryngeal carcinoma submucosal infiltrating distance was measured under microscope.Laryngeal carcinoma latent submucosal infiltrating extent was compared among different location,different T staging and external appearance.RESULTS Basing on tumor external appearance and infiltrating extent,laryngeal carcinoma was classified into three types:exogenic type,ulcerating infiltrating type and mixed infiltrating type.Of 43 specimens,the three types were 10,8 and 25 cases respectively.There was a significant difference in submucosal infiltrating extent between T1～T2 and T3～T4 laryngeal carcinoma.There was also significant difference in submucosal infiltrating extent between exogenic type and ulcerating infiltrating type or mixed infiltrating type.CONCLUSION The submucosal infiltrating extent of laryngeal carcinoma tissue plays an important role in the surgical margin. As laryngeal carcinoma T stage developing,tumor submucosal infiltrating extent is becoming more extensive.Laryngeal carcinoma submucosal infiltrating extents in ulcerating infiltrating and mixed infiltrating type are more extensive than that in exogenic type.The partial laryngectomy should be prudent to be performed in cases with local advanced ulcerating infiltrating and mixed infiltrating laryngeal carcinoma.

Objective To identify histopathologic correlates for the various MRI appearances of breast fibroadenomas.Methods Thirty-eight fibroadenomas in 33 patients(aged 24—57 years)examined with gadolonium-enhanced MR imaging were observed for signal intensity on T_2-weighted images,contrast enhancement,shape,and internal septation,and these findings were correlated with histopathologic findings.All cases underwent surgery and were proved by pathology.Results(1)The lesion shape was lobular,or round in 34 of 38 fibroadenomas(89.5%).(2)The signal intensity on T_1-weighted images was less than or equal to that of fibroglandular tissue in all cases.The signal intensity on T_2-weighted images was highly varible:high T_2 signal intensity was associated with more myxomatous stromal(mean myxoid-sclerotic index value of 1.9),higher stromal cellularity(mean stromal cellularity index value of 2.2); Fibroadenomas with low T_2 signal intensity had stromal that was nearly uniformly sclerotic(mean myxoid- sclerotic index values of 2.8)and low stromal cellularity(mean stromal-cellularity index value of 1.2). Significant differences were found between these two groups,x~2=11.267 and x~2=10.415(P0.05).The degree of contrast enhancement was proved to be related to ages of patients.The enhancement was more intensely in younger patients.(5)Internal septations were identified within nine of 33 enhancing fibroadenomas (27.3%)and appeared to correlated with collagenous bands at histopatholigic analysis.Conclusions Fibroadenomas demonstrate marked histopathologic variability.The resultant variability in the MR appearance correlated with the degree of myxomatous or sclerotic and stromal cellularity.Lobulation and internal septation,which appear to reflect intrinsic growth patterns of fibroadenomas,may provide more reliable information for distinction.Familiarity with the diagnostic features would facilitate to make the differential diagnosis correctly.