Objective To research the nutritive condition and establish prediction model of chlorophyll-a(Chla) in a surface water source of Zhengzhou, China. Methods The water temperature(WT), Secchi-depth(SD), chemical oxygen demand(CODMn), total nitrogen(TN), total phosphorus(TP), Chla were determined in two sampling sites of the water source by standardized methods from Mar, 2004 to Oct, 2004. Nutritive condition of the water source was analyzed by trophic level index(?)[TLI(?)]. The influence of some environmental factors on Chla was analyzed by correlation analysis and stepwise multiple regression. Chla was predicted by establishing a stepwise multiple regression equation. Results In the spring, summer and autumn, nutritive condition of the water source was from the maximum of mesotropher, the maximum of light eutropher to the minimum of middle eutropher. A positive correlations were found between the standardized Chla and WT, CODMn, TP. A negative correlation was found between the standardized Chla and SD. The equation was ln(CChla+1)=-0.114+0.083 48 WT+6.874 TP+0.193 CODMn(R2=0.900, F=62.674, P

0.05; the holding vs neutral position, the disaster side and the healthy side all had significant difference,P0.05.This showed that the capability of stability of a-c joint were good. The Roentgenograms of shoulder elevation position raise showed that there was no impact in the a-c joint.[Conclusion]The results of small incision Dewar's operation is good in treating instability distal clavicular fracture.It has the advantages of minimally invasive,easy operation and fixation.

Objective To investigate the feasibility and superiority of the lecture based learning (LBL)combined problem-based learning (PBL)for endocrinology teaching practice. Methods Totally 150 clinic medical undergraduates were randomly divided into three groups:LBL group (n=50),PBL group (n=50)and LBL+PBL group (n=50). Questionnaires,written and oral tests were employed to evaluate the teaching effect. ANOVA was used to compare the indicator scores and chi-square test was used to compare grades and passing rate. Results Teaching efficiency,mater of knowledge,capabilities of analysis,teaming and collaboration ability and medical diagnosis thinking cultivation were better in LBL and PBL group than in the other two groups. There were statistical differences in total score(F=4.69, P=0.010)and passing rate(χ2=8.94,P=0.030)among three groups. Conclusions LBL+PBL guarantee the teaching quality and cultivate the comprehensive quality of students; therefore it is superior to LBL and PBL.

Objective To enhance the understanding of chest primitive neuroectodermal tumor (PNET) and improve the results of management. Methods The results of 10 cases of chest PNET, which had been surgically treated and pathologically confirmed from 1999 to 2004 were retrospectively analyzed. Results There were 6 intrathoracic tumors, 2 in the chest wall, 1 in the pericardium, and 1 in the posterior mediastinum. Two intrathoracic tumors were completely resected, 2 partially resected, tumor and the involved lung were removed in 2 cases. Two had tumor with the affected ribs removed and the chest wall reconstructed. Tumor and the invaded pericardium were removed in 1 case. The PNET in the posterior mediastinum, invading into spinal canal as a bell tumor, was excised by the thoracic surgeon cooperating with neurosurgeon. There was no hospitalization death. All the specimens demonstrated positive reaction to CD99 and negative to LCA. 4 cases received postoperatively adjuvant chemotherapy, 4 radiotherapy and chemotherapy, the other 2 cases had none adjuvant therapy. 7 patients died during 6 years of follow-up, with 9 to 27 months survival. 3 patients are alive and have over 12 months survival so far. Conclusion PNET is an aggressive and invasive malignant tumor with poor prognosis. Difficulties exist in diagnosis. Besides common microscopic examination, pathological histology and immunochemistry, even electron microscopic examination may be required in differential diagnosis. Complete removal of tumor and involved tissue plays an important role, postoperative adjuvant therapy, including radiotherapy or combination with chemotherapy, may prolong survival. Modalities that are more effective should be developed to improve the treatment results.

Objective To develop the formulation of self-microemulsifying drug delivery system for hawthorn leaves flavonoids (HAW-SMEDDS). Methods The optimum formulations of oil phase, surfactant, and assistant surfactant for HAW-SMEDDS were screened by solubility test, compatibility test, and pseudo-ternary phase diagrams, with the time of formulating microemulsion, the consequence of visual examination, and particle size as indexes. The dissolution of HAW-SMEDDS was measured, taking the commercial tablet Yixintong Tablet as reference. Results The optimum self-microemulsifying drug delivery system was composed of Labrasol (35%), Transcutol P (10%). The particle diameter was (39.5?5.4) nm, the time of self-microemulsifying was less than 1 min. The percent of accumulated dissolution of hawthorn leaves flavonoids in SMEDDS in distilled water was up to 70% at 10 min, while that in the Yixintong Tablet was less than 50% at 60 min. Conclusion The formulation of HAW-SMEDDS preparation could meet the request of the design. It could provide the reference for the new dosage form.

Objective To explore the clinical efficacy of small-incision Dewar's operation for acute acromioclavicular dislocation.Methods Without exposing the a-c joint,the coracoid tip with tendon were transferred to the clavicle to reconstruct the coracoclavicular ligaments.And then the a-c joint was statically fixed and dynamically replaced.Results A 1-to 9-year follow-up(mean,4.9 years)was available in 52 patients.According to the Lazzcano Criteria,44 cases had excellent and 7 cases had good results,only one was failed because of bolt prematurity at 2 month after the operation.Roentgenogram,CT,and MRI showed that the surface of the acromioclavicular joint was smooth,no arthritic sign of cirrhosis,hyperplasia,or theca.The signal of the a-c joint was uniform.The Roentgenograms showed that,at the neutrality position,the distal end of the clavicle of the injured side was higher than that of the healthy side.The D/W of the healthy side was 0.432?0.101,which was significantly higher than that in the injured side(0.523?0.083,t=2.188,P=0.042).The difference between the neutrality and hold of the healthy side was 0.116?0.025,while that of the injured side was 0.087?0.016(t=1.114,P=0.280).The Roentgenograms of the raise position showed no impact in the a-c joint.Conclusions Small incision Dewar's operation is an effective,safe,and minimally invasive method for the treatment of acute acromioclavicular dislocation.

Objective To compare the diagnostic value of digital breast tomosynthesis (DBT) versus digital mammography (DM) in the evaluation mass like lesions in dense breasts. Methods Eight hundred and fifty eight patients, who had DBT and DM, with breast diseases confirmed by pathology were retrospectively reviewed. The breast density and the imaging features were classified according to the standard of American College of Radiology(2013) and breast imaging reporting and data system (BI?RADS) scores. Six hundred and thirty one patients with mass lesions in dense breasts were chosen to included. All 631 patients had DM of both breasts and DBT of affected breast prior to mastectomy. Pathological results were used as the golden standard. Detection rate and diagnostic accuracy of masses, sensitivity and specificity of diagnosis, false negative and recall rates, the margins and spicules and BI?RADS category were calculated. The detection rate and diagnostic accuracy, the margins and spicules of masses were compared with Chi?square test, the BI?RADS scores were analyzed with rank test. Results With DBT, average detection rate increased from 77.3%(488/631) to 84.3% (532/631), average diagnostic accuracy rate increased from 73.4%(463/631) to 82.3%(519/631),with statistical significant difference between groups (c2=27.191,36.890,P<0.01).Sensitivity for DBT and DM were 68.1%(205/301) and 58.8%(177/301), respectively. Specificity for DBT and DM were 95.2%(314/330)and 86.7%(286/330), respectively. Recall rate for DBT and DM were 3.6%(23/631)and 9.8%(62/631), respectively. One hundred and seventy two cases and 75 cases with circumscribed masses of benign cases were detected by DBT and DM, respectively. One hundred and eighty-two cases and 115 cases with spiculated masses of malignant cases were detected by DBT and DM, respectively, with statistical significant difference between groups (c2=70.471 and 21.707, P<0.01). Of 330 malignant cases, the numbers of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 19,4,8,13,52,93,141, respectively, the numbers on DBT images were 3,1,7,5,52,83,179, respectively, with statistical significant difference(Z=-2.235,P=0.025). Of 301 benign cases, the number of BI?RADS category 0, 2, 3, 4A, 4B, 4C, 5 on DM images were 43,10,60,117,58,11,2, respectively, the number on DBT images were 20,4,64,150,55,7,1, respectively, with no statistical significant difference between groups(Z=-1.846,P=0.065). Conclusion DBT significantly improves the detection of mass?like lesions in dense breasts, display of mass margin and architectural distortion of surrounding tissue.

Objective To analyze changes in lactic acid level in patients with late-onset intracranial hematoma after craniocerebral injury and investigate their relativity.Methods Forty-eight patients with late-onset intracranial hematoma after craniocerebral injury treated in our hospital between May 2009 and December 2012 were enrolled as observation group.There were 32 males and 16 females.Moreover,50 cases checked up in our hospital during the same period were studied as health population controls,including 35 males and 15 females.Level of lactic acid was measured on admission,at the time of definite diagnosis as well as at days 7 and 14 after treatment and compared between groups.Results Level of lactic acid was (1.77 ±0.21) mmol/L in control group and (1.82 ± 0.25) mmol/L in observation group respectively on admission (t =1.070,P ＞ 0.05) ; Level of lactic acid was (3.32 ± 0.89) mmol/L in observation group at the time of definite diagnosis,which increased to (3.74 ± 1.16) mmol/L at days 7 after treatment and decreased to (1.89 ±0.75) mmol/L at days 14 after treatment.When diagnosed and treated for 7 days,level of lactic acid differed significantly between the two groups (P ＜ 0.05).Level of lactic acid related to craniocerebral injury at each time point,but higher correlation coefficient was observed at the time of definite diagnosis and 7 days after treatment with 0.986 and 0.989 respectively.Conclusion Level of lactic acid relates to late-onset intracranial hematoma after craniocerebral injury,which can be used as reference for progression of the disease.

Objective To analyze the X-ray,CT and MRI appearances of primary synovial osteochondromatosis.Methods CT scanning was performed in 22 cases,of which 16 cases underwent X-ray examination and 2 cases underwent MRI scan.Results Of 22 cases of synovial osteochondromatosis,13 cases were male and 9 cases were female.The monoarticular involvment was found in 20 cases,and double-articular involvment in 2 cases.Variable size and number of the cartilaginous nodules with calcification and ossification within and surround the joints were showed in 20 cases.The soft mass with calcification were showed in 2 cases.Bone destruction were found in 2 cases,which were induced by compression of the cartilaginous nodules,this was confirmed by operations.Conclusion The cartilaginous nodules with calcification or ossification can be shown by X-ray and CT san.The cartilaginous nodules without calcification or ossification can be shown by MR san.

OBJECTIVE:To establish a method for the determination of dissolution of Xiaocaihu pill,and compare the differ-ence of preparation from different manufacturers. METHODS:Using 0.1 mol/L HCl as dissolution medium,rotating basket method was used to determine the dissolution of preparations. HPLC was adopted to determine the content of baicalin:column was TSKgel ODS C18 with mobile phase of methanol-water-phosphoric acid (65∶35∶0.7,V/V/V) at a flow rate of 1 ml/min,detection wave-length was 280 nm,column temperature was 30 ℃,and injection volume was 5 μl. RESULTS:The linear range of baicalin was 0.488-124.8 mg/L (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recovery was 100.14%-104.78%(RSD=1.58%,n=9). The average t50(50% dissolution time)of baicalin was 85.81 min. CONCLUSIONS:The method is simple with good precision,stability and reproducibility,and can be used for the dissolution determination of Xiaocaihu pill. Xiaocaihu pill from different manufacturers shows great differences,both preparation formulation and clinical use should attach importance to the dissolution of solid preparations.