Objective:To simultaneously determine the contents of ginsenoside Rb1 , ginsenoside Rb2 , ginsenoside Rb3 , ginsen-oside Re, ginsenoside Rg1 , ginsenoside Rf and ginsenoside Ro in Qipi pills by HPLC-QTOF-MS. Methods: The determination was performed on an Agilent Poroshell 120 EC-C18 column (2. 1 mm × 50 mm,2. 7 mm) with mobile phase consisting of acetonitrile( A)-water(B, containing 0. 1% formic acid) with gradient elution. The flow rate was 0. 21 ml·min-1. The column temperature was 30℃. The MS instrument was equipped with an ESI+ ion source. The exacted ion chromatograms were used to determine the quantities of different compounds in the samples while the mass spectra of product ions were used for confirming the compounds. Results:All the 7 kinds of ginsenoside showed good linearity (r>0. 9993). The RSDs of precision, repeatability and stability tests were all less than 5%. The average recoveries were within the range of 97. 11%-101. 98%. Conclusion:The method is simple, rapid and reliable with high specificity, which can be used for the quality control of Qipi pills.

Objective To evaluate the application of tubular stomach gastroesophagostomy on the life quality after esophagectomy surgery.Methods From March 2011 to September 2011,66 cases of esophageal cancer patients were divided in two groups in randomized principles.Tirty-four cases in group of tubiform gastro surgery whose the stomach was cut into tubiform stomach in width of 4 cm.And 32 cases of conventional group and whose surgery method was adopted to maintain whole stomach but cut the cardia.And then,using statistical methods,life quality after esophagectomy (treatment related symptoms,general symptoms,daily life,social life,emotional activities) and the perioperative complications were evaluated in 3,6,12,24 months in comparison and analysis.Results Sixty-six surgeries of both group patients were successfully performed,tumor resection rate was 100％,and there was no intraoperative accident also no perioperative death.There was no statistical significance of perioperative complications of 2 groups (P ＞ 0.05).Life quality of tubiform gastro group had improved apparently more than conventional group at the 3rd,6th,12th and 24th month after surgery(78.68 ±2.23 vs 65.94± 4.13,83.79 ± 2.40 vs 66.84 ± 5.86,86.41 ± 1.94 vs 67.09 ± 4.43,89.02 ± 1.71 vs 68.88 ±3.53,P＜0.05).At each time point,there were statistically significant differences between tubiform gastro group and conventional group on treatment related symptoms,general symptoms,daily life,emotion activities (P ＜0.05).At the 3rd,6th month after surgery,tubiform gastro group and the conventional group had no statistically significant difference in the aspect of social life (P＞0.05).In the conventional group,the evaluation of quality of life at each time point after surgery and before a point in time in the same group showed no statistical significance (P＞0.05).Conclusion Tubiform gastro esophagectomy has a positive influence on life quality of patients of esophageal cancer after surgery prospectively.

Objective:To develop a method of quantitative analysis of multi-components by single marker( QAMS) for nine kinds of alkaloids in Xiaohuoluo pills. Methods: An HPLC-QTOF-MS method with an Agilent ZORBAX Extend-C18 RRHT(2. 1 mm × 50 mm,1. 8 μm) column was applied. The flow rate was 0. 21 ml·min-1 . The column temperature was 30 ℃. The mobile phase was methanol (A)-water (B;containing 0. 1％ formic acid and 2. 5 mmol·L-1 ammonium acetate) with gradient elution. The aconitine was used as the internal standard, and the relative correction factor ( RCFs) of hypaconitine, mesaconitine, benzoylaconine, benzoyl-hypaconine, benzoylmesaconine, aconine, hypaconine and mesaconine was respectively established, and the reproducibility inspection on the RCF was performed. The contents of the other 8 kinds of aconitum alkaloids were calculated according to the RCF. At the same time, an external standard method ( ESM) was performed for the content determination of the nine alkaloids. The results of the two methods were compared. The feasibility and accuracy of the QAMS method were verified. Results:Within a certain range,the RCF of hypacontine,mesacontine, benzoylaconine, benzoylhypaconine, benzoyl mesaconine, aconine, hypaconine and mesaconine to aconitine was 1. 736,1. 979,1. 0471,0. 9242,1. 2901,1. 3078,1. 2859,and 1. 0948,respectively. The QAMS method was established for determi-ning alkaloids. There were no significant differences between the results of the QAMS method and those of the external standard method ( ESM) . Conclusion:With the validation of methodology, the method established in our study can be used for the content determina-tion of aconitine, hypaconitine, mesaconitine, benzoylaconine, benzoylhypaconine, benzoylmesaconine, aconine, hypaconine and mesaconine in xiaohuoluo pills.

Objective: To investigate the hydrolysis conversion rate of alcohol amine-diterpene alkaloids from aconitum alkaloids, hydrolyze aconitum alkaloids reference substance, calculate the amount of alcohol amine-diterpene alkaloids in the hydrolysis solution by the hydrolysis conversion rate, which is used as the amount of alcohol amine-diterpene alkaloids reference substance, and establish a content determination method for aconine, hypaconitine and aconine in Aconiti radix cocta.Methods: Through controlling the hydrolysis conditions of aconitine, hypaconitine and mesaconitine, aconine, hypaconitine and aconine were obtained.The determination was performed on an Agilent ZORBAX Extend-C18 RRHT(2.1 mm×50 mm,1.8 μm) column with the mobile phase consisting of methanol(A)-water(B containing 0.1% formic acid and 2.5 mmol·L-1 ammonium acetate) with gradient elution by HPLC-QTOF-MS.The flow rate was 0.21 ml·min-1.The column temperature was 30 ℃.MS instrument was equipped with an ESI+ ion source.Results: Under the hydrolysis conditions of this study, the conversion rate of aconine from aconitine was 99.64%;the conversion rate of hypaconitine from hypaconine was 99.94%;the conversion rate of mesaconitine from mesaconine was 99.57%.The HPLC-QTOF-MS methodological investigation showed the 3 kinds of alcohol amine-diterpene alkaloids were with good linearity (r>0.999 1).The RSD of the precision, repeatability and stability tests were less than 5%.The average recoveries were within the range of 99.43%-100.10%.Conclusion: The validated method is simple, specific, reliable and reproducible.In the absence of reference substance, it can be used for the quality control of the herbs of Aconitum L.species.

Objective To investigate the effect of moldavica total flavone on pulmonary function and collagen type Ⅲ in lung tissue of ovalbumin-induced bronchial asthmatic rats. Methods A total of 60 SD rats were randomly divided into control group, model group, dexamethasone group, and moldavica total flavone low, medium and high dose group. Rat asthma model was established by ovalbumin challenge methods except the control group. The control and model group were intragastrically given distilled water, medicine groups were intragastrically given moldavica total flavone and dexamethasone for 30 d, once per day. After the last administration, the pulmonary function and airway responsiveness including breathing frequency (F), minute ventilation (MVb), peak inspiratory flow (PIFb), peak expiratory flow (PEFb) and enhanced pause (Penh) were measured by using non-invasive measurement system (Penh system, Buxco, USA). The collagen type Ⅲ in lung tissue were detected by ELISA. Results The moldavica total flavone at 180 and 360 mg/kg decreased F and Penh (P<0.05, P<0.01), increased MVb, PIFb and PEFb (P<0.05), and decreased collagen type Ⅲ in lung tissue (P<0.05, P<0.01). Conclusion Moldavica total flavone can relieve the airway hyperresponsiveness and remodeling, improve respiratory function of ovalbumin-induced bronchial asthmatic rats.

Objective To evaluate the accuracy, of different threshold segmentation of 18FDG PET for target volume delineation of non-small cell lung cancer(NSCLC) and the potential influence on radiotherapy treatment planning. Methods Eight NSCLC patients who had tumor with clear margin on CT scan and the amplitude of tumor movements not more than 5 mm were enrolled. PET scans were carried out at 1 h after intravenous injection of 18FDG with CT image for attenuation revisement. Gross target volume (GTV) delineated on CT image ( GTVCT ) was used as the standard. Then, GTVs were delineated on PET image with three different threshold segmentation of 42% Imax(total) (42% of maximum voxel intensity within the tumor) ,Iback + 20% Imax-back(max) (mean background intensity + 20% of normalized background-subtracted maximum voxel intensity within the tumor) and Iback -20% Imax-back(slice) (mean background intensity + 20% of normalized background-subtracted maximum voxel intensity of each slice within the tumor) ,the corresponding GTV was named as GTV42%, GTV20%max and GTV20%slice. Both the size of GTV42%, GTV20%max, GTV20%slice and GTVCT,and the coverage over GTVCT for each GTV were compared. A three dimensional margin of 1 cm were added to GTVCT, GTV42%, GTV20%max and GTV20%slice to form corresponding PTVCT, PTV42%, PTV20%max and PTV20%slic e. Three dimensional conformal radiotherapy treatment plans were designed based on PTVCT,PTV42% , PTV20%max and PTV20%slice respectively for each patient. The prescription dose of all PTVs was 66 Gy in 33 fractions in 6.6 weeks. Both the volume accepting dose less than 95% of prescription dose within PTVCT ( VPTV ) and the lung V20 were compared among the four plans based on different PTVs. Tumor control probability(TCP) as well as lung normal tissue complication probability (NTCP) were also compared. Resuits Eight patients were enrolled in this study. Median deviation of volume between GTVPET and GTVCT were -54.1% , -21.5 % and 5.3 % for GTV42% , GTV20%max and GTV20%slice, respectively. Median coverage over GTVCT of GTV42% , GTV20%max and GTV20%slice was 45.9% ,78.0% and 95.3% respectively( F = 57.50,P＜0.01). Median 7.5% of VPTV was observed for radiotherapy treatment plan based on PTV42% ,which meant that it might induce median 1% decrease of TCP comparing with that of radiotherapy treatment plan based on PTVCT. Whereas,there were only 1.3% and 0.0% of VPTV for treatment plans based on PTV20%max and PTV20%slice respectively. As far as TCP was concemed, both PTV20%max group and PTV20%slice group were superior to PTV42% group,there was no significant difference among PTV20%max group, PTV20%slice group and PTVCT group. Lung V20 and lung NTCP showed no significant difference among all groups. Conclusions The threshold segmentation of Iback + 20% Imax-back(slice) , being slice specialized, might be an optimal threshold segmentation for target volume delineation of lung caner. Independent of information of target volume provided by CT scan in advance,it is recommended to use for the target volume delineation of NSCLC with atelectasis.

Objective To evaluate clinical outcomes of treating displaced intra-articular calcaneal fractures with Orthofix external fixation (EF) in comparison with open reduction and internal fixation (ORIF).Methods Between February 2013 and December 2014,39 patients with 41 calcaneal fractures were treated operatively and fully followed up at our department.They were 27 men and 12 women,aged from 27 to 56 years(average,42.5 years).The left foot was affected in 15 cases and the right in 26.By the Sanders classification,there were 11 cases of type Ⅱ,22 ones of type Ⅲ and 8 ones of type Ⅳ.The 5 open fractures were Gustilo type Ⅰ (2 cases) and Gustilo type Ⅱ (3 cases).Of the 11 fractures complicated with soft tissue injury,4 were Tscherne-Oestern type Ⅰ and 7 Tscherne-Oestern type Ⅱ.The patients were divided into group EF (25 cases) and group ORIF (16 cases) according to the operation they had received.The 2 groups were compared in intraoperative indexes and follow-up radiological data.The American Orthopaedic Foot and Ankle Society (AOFAS) scores for ankle and hindfoot were recorded at the final follow-up for every patient.Results The mean duration of surgery,intraoperative bleeding,time for hospitalization and bone healing in group EF were significantly less than in group ORIF (P ＜ 0.05).There were no significant differences between the 2 groups in follow-up duration,AOFAS score,Bthler angle,Gissane angle,calcaneal axis,calcaneal horizontal length,tuberosity height,hillock calcaneal height,calcaneal width,or talar inclination angle (P ＞ 0.05).According to the AOFAS scores at the final follow-ups,15 cases were rated as excellent,8 as good and 2 as fair in group EF while 10 were rated as excellent,5 as good and one as fair in group ORIF.Conclusions All types of calcaneal fracture can be treated using Orthofix external fixation which may lead to advantages of earlier surgery regardless of soft tissue condition,minimal invasiveness with less devascularization to the calcaneus and decreased risk of complications,and good clinical outcomes.

Objective To evaluate the efficacy and safety of double dosage Tamsulosin in treating patients with type Ⅲ prostatitis.Methods According to the results of prostate secretion(EPS) examination and the national institute health-chronic prostatitis symptom index(NIH-CPSI) questionnaire,120 patients with type Ⅲ prostatitis were recruited and randomly divided into single dosage group (n =60),treated with 0.2 mg Tamsulosin and placebo once daily for 12 weeks,and double dosage group (n =60),treated with 0.4mg Tamsulosin once daily for 12 weeks.Before treatment,the NIH-CPSI total scores in single and double dosage group were 26.91 ± 4.08 and 27.31 ± 4.98,respectively.The pain index in each group was 10.64±2.23 and 11.47 ± 3.00,respectively.The voiding index was 6.52 ± 2.24 and 6.41 ± 2.97 respectively.In those groups,the quality of life index was 9.68 ± 1.81 and 9.45 ± 1.79,respectively.All those items didn't show significant difference among those groups (P ＞ 0.05).The patients were follow-up and evaluate by those items on weeks 12.Results Because of losing during follow-up,4 patients were excluded from single dosage group.2 patients were excluded from double dosage group.After treatment in single dosage group,the NIH-CPSI total scores were 12.11 ± 3.60,pain index were 3.57 ± 1.67,voiding index were 2.88 ± 1.70,quality of life index were5.59 ± 2.06.After treatment in double dosage group,the NIH-CPSI total scores were 9.90 ± 4.15,pain index were 3.21 ± 2.21,voiding index were 2.21 ± 2.11,quality of life index were 4.50 ± 1.97.After 12 weeks treatment,the NIH-CPSI total scores,pain index,voiding index,quality of life index in both two groups were improved (P ＜ 0.05),and the double dosage group improve better(P ＜ 0.05).In the course of treatment,there were 2 cases of patients (3.8％) with adverse drug reactions in single dosage group,including dizziness in 1 case,headache in 1 cases.There were 4 cases of patients (6.9％) with adverse drug reactions in double dosage group,including dizziness in 3 cases of and rhinitis in 1 case.The rate of adverse reactions had no significant differences in the two groups (P ＞ 0.05).Conclusions Compared with single dosage Tamsulosin in the treatment of type Ⅲ prostatitis,double therapy had a better efficacy.Double dosage Tamsulosin therapy had an equal safety to the single dosage Tamsulosin.

Objective To evaluate the feasibility and safety of transumbilical laparoendoscopic sin-gle-site dismembered pyeloplasty ( U-LESS-P ) for the treatment of ureteropelvic junction obstruction (UPJO). Methods Between Mar.2011 and Mar.2012, U-LESS-P was performed in 8 consecutive pa-tients with UPJO by one experienced laparoscopic surgeon .The patients included 5 males and 3 females, with an average age of 28 (16-45) years.Of the 8 patients, six presented with flank pain , and two were a-symptomatic and discovered incidentally by health check .Of the 8 patients, seven had UPJO on the left side and one on the right side .The diagnosis was established by renal ultrasonography , diuretic renal scan , intra-venous urography (IVU) or/and computed tomography urography (CTU).Renal ultrasonography, IVU and ( or) CTU showed hydronephrosis and UPJO in the affected side , while diuretic renal scan demonstrated re-nal function deteriorated .No patients had undergone abdominal surgery previously .A 2-2.5 cm umbilical in-cision was made for single-port access .The procedures were performed using 30°5 mm or 10 mm laparoscope with a combination of conventional and bent laparoscopic instruments . Results All procedures were com-pleted successfully .None was converted to open surgery or traditional laparoscopic surgery .The mean opera-tive time was 153 (117-190) min, and the average estimated blood loss about 20 (10-40) ml.The mean time to resume oral diet was 1.5 days.The drainage remained 2-7 days.The mean hospital stay was 6 (4-8) days.With the follow-up of 3-6 months, symptom-free was investigated in all 8 cases.Ultrasonography , diuretic renal scan and IVU showed decreased or disappeared hydronephrosis .No operative complication , such as anastomotic stoma stenosis , was founded . Conclusions U-LESS-P is a safe and effective proce-dure for the treatment of UPJO , with the advantages of decreased operative morbidity , postoperative rapid re-covery and improved cosmetic result .

Objective:To better promote the standardization of public health management in China, and provide evidence for the development and improvement of the standardization strategy and management system in public health field in China.Methods:This paper summarizes and analyzes the information about the standardized management mechanism collected from international organizations related with standardization in public health.Results:The standards in public health varied in different management systems of the international organizations, and there were great differences in organization nature, standard types, application, release, organization structure, standard development principles, advantages, transformation, promotion and implementation, and evaluation.Conclusion:China can benefit from the studying of the working mechanism of the international organization related with standardization in public health to facilitate its own standardization in public health.