This article discusses the practice of GMP in producing hospital pharmaceutical preparatioon in regard to the following points: 1. necessity and feasibility, 2. key links to be grasped, and 3. effective organizing work.

Objective:To research the quality standard for Xilei San. Methods:Imdigo naturalis and calculus bovis were identi-fied by TLC and their contents were determined by HPLC, and Borneolum syntheticum was determined by GC. Results: Indirubin showed good linearity over the concentration range of 0. 043-4. 255 0 μg(r=0. 999 2) with the average recovery of 97. 9%(RSD=1.5%,n=6). Bilirubin showed good linearity over the concentration range of 9.968 ×10 -4-9.968 ×10 -2 μg(r=0.999 9) with the average recovery of 95.3%(RSD =0.55%, n =6). Borneolum syntheticum showed good linearity over the concentration range of 0. 010 3-0. 826 6 mg(r=0. 999 8) with the average recovery of 94. 9%(RSD=3. 2%,n=6). Conclusion: The method is accurate with good reproducibility,which can be used as the quality control for Xilei San.

AIM:To establish a method for determining menthol, methyl salicylate,cinnamal dehyde and engenol simultaneously in Baicao Oil by GC. METHODS: A separation was performed on a large bore capillary column(30m?0.53mm) with PEG-20M as the stationary phase of GC.The method was carried out with FID as the detector without split stream sampling.A programmed temperature was employed.Benzyl alcohol was selected as the internal standard substance. RESULTS: An excellent seperation of menthol,methyl salicylate,cinnamal and engenol in Baicao Oil was gained.The good linear relationships of menthol (62.7?10~3-2.01?10~3 ?g/mL),methyl salicylate (119?10~3-3.81?10~3 ?g/mL),cinnamal dehyde (0.42-205 ?g/mL),engenol (19.9-636 ?g/mL) were observed.All correlation coefficients were greater than (0.999 2).The average recovery of menthol,methyl salicylate,cinnamal and engenol were between(98.6%)～100.3%,and RSD was less than 2.4%. CONCLUSION: The method is simple,accurate and suitable for quality control of Baicao Oil.

Objective: To investigate the prevalence and types of maternal near miss in Hangzhou City from 2015 to 2020, so as to provide insights into early identification and interventions for maternal near miss. Methods: The data of maternal near miss in 5 hospitals of Hangzhou City from 2015 to 2020 were collected from China's National Maternal Near Miss Obstetrics Surveillance System, and the incidence and mortality of maternal near miss, types of pregnancy-related complications/comorbidities and types of critical illness were descriptively analyzed. Results: Totally 230 490 pregnant and lying-in women were recruited in 5 hospitals in Hangzhou City from 2015 to 2020, and there were 182 514 live births, 177 428 women with pregnancy-related complications/comorbidities, and 1 790 cases of maternal near miss with a 0.98% annual incidence rate. The incidence of maternal near miss was high in 2019 (1.18%). The hospital mortality and death index were respectively 3.29/105 and 0.33% among pregnant and lying-in women from 2015 to 2020, and there was no death found among pregnant and lying-in women from 2018 to 2020. The main pregnancy-related complications/comorbidities included anemia (79.33%), obstetric hemorrhagic disorders (69.83%), and gestational hypertension (16.65%). The main critical illness among maternal near miss included coagulation dysfunction (87.23/104), cardiovascular dysfunction (20.44/104), and respiratory dysfunction (9.70/104). Conclusions The incidence of maternal near miss was high and the hospital mortality appeared a reduction tendency among pregnant and lying-in women in Hangzhou City from 2015 to 2020. Coagulation dysfunction is the primary critical illness among maternal near miss, and the management of anemia and hemorrhagic diseases requires to be improved.

Objective:To investigate the clinical efficacy and outcomes of two separate vertical wiring combined with tension band and Kirschner-wire plus cerclage wire in the treatment of displaced inferior pole fractures of the patella.Methods:From January 201 3 to January 201 5,1 5 consecutive patients (mean age 54.5 years)with inferior pole fractures of the patella were retrospectively included in this study.All the patients underwent open reduction and internal fixation by separate vertical wiring com-bined with tension band and Kirschner-wire plus cerclage wire through longitudinal incision,4.5 d (range:3.1 -5.9 d)after initial injury.A safety check for early knee range of motion was performed before wound closure.The complications including infection,nonunion,loss of fixation and any wire breakage or irritation from implant were recorded.Anteroposterior and lateral views of the knee joint ob-tained during the follow-up were used to assess bony union based on the time when the fracture line disap-peared.At the time of the final outpatient follow up,functional evaluation of the knee joint was conduc-ted by B?stman system.Results:The follow-up time was 1 3.1 months (range:1 2 -1 9 months)after surgery on average,immediate motion without immobilization in all the cases was allowed and there was no case of reduction loss of the fracture and wire breakage.There was no case of irritation from the im-plant.At the final follow-up,the average range of motion (ROM)arc was 1 26.7°(range:1 1 5°-1 40°),the average ROMlag versus contralateral healthy leg was 1 0.3°(range:0°-35°).The mean B?stman score at the last follow-up was 28.9 (range:27 -30),and graded excellent in most cases. Conclusion:Two separate vertical wiring is an easy and effective method to reduce the displaced inferior pole fracture of patella.Augmentation of separate vertical wiring with tension band and Kirschner-wire plus cerclage wire in these patients provides enough strength to protected the early exercise of the knee joint and uneventful healing.By this surgical treatment,excellent results in knee function can be expec-ted for cases of displaced inferior pole fractures of the patella.

Objective To evaluate the diagnostic value of three-dimensional CT(3DCT)in atlantoaxial lesions.Methods The findings of 3DCT were analyzed and compared with conventional CT and radiography in 124 patients with atlantoaxial disease.Results 124 cases of atlantoaxial lesion included fracture in 42,atlantoaxial rotatory dislocation in 73,hypoplasia of the dens in 4,and congenital atlantoaxial deformity in 5.Among the 124 cases,89 cases were diagnosed by X-ray,109 cases by conventional CT,121 cases by MIP,122 cases by SSD,124 cases by MPR and VR.Conclusion 3DCT can find the slight rotatory dislocation,so it is the most effective means for the diagnosis of atlantoaxial rotatory dislocation.3D and MPR of spiral CT are useful in the diagnosis of atantoaxial fracture.Combining conventional CT and X-ray film with 3DCT can improve the acuracy of the diagnosis.

Objective To report the experience on the modified Abb? flap for correction of mild tightness of the corrected cleft lip deformity. Methods Forty-two patients with a mild or moderately tight lip deformity after primary unilateral cleft lip repair were performed a modified Abb? flap for correcting tight upper lip. The operative technique was that the pocket was creased for the vermilion tubercle by splitting the lip. The skin was incised several millimeters beyond the vermilion-skin border and was moved laterally for a distance equal to the breadth of the vermilion tubercle. The orbicularis oris muscle and the full length of the upper lip vermilion were incised. By releasing the tension, the slight concavity, expressed in profile by the slight pout which a normal upper lip had in cross section, was obtained. The Abb? flap that was taken from the central portion of the lower lip vermilion, was designed to repair the vermilion tubercle and the Cupid's bow. The flap was approximately 8 mm in width. The full length of the lower lip vermilion and the orbicularis oris muscle were incorporated. A ting portion of skin was included, which facilitated closure of the donor site, The flap, based on the labial vessels, was rotated 180?and sutured into the created defect of the upper lip. The pedicle was divided 10 days after operation. Results Forty-two patients all showed an obvious Cupid's bow, Cupid's bow peak, the median tubercle and the height and width of the upper lip. The scarring of the base of the nose was not obvious. Conclusion Use of modified Abb? flap to reconstruct the contour of the upper lip is successful in patients with cleft lip.

Objective To investigate tile clinical significance of IL-13 gene expression in peripheral blood mononuclear cell(PBMC) and level of plasma IL-13 from patients with lupus nephritis(LN). Methods Ten healthy volunteers and 16 patients with LN were included in this study. All patients had been performed percutaneous renal biopsy and examined by light and immunofluorescence microscopy. The expression of IL-13 nRNA in PBMC was evaluated by RT-PCR. The level of plasma IL-13 was determined using an IL-13 specific ELISA. Results The expression of IL-13 mRNA in PBMC and the levels of Plasma IL-13 from patients with LN were significantly higher than those of the controls(l .99 ? 0.29 vs 0.68 ? 0. 15, P

Objective The expression of IL-13 in plasma and renal tissue was studied to eluciate the molecular pathogenesis of Mesangial proliferative glomerulonephritis (MsPGN). Methods Plasma level of IL-13 in patients with MsPGN and in normal control groups were examined by ELISA. The expression of IL-13 in patients with MsPGN and in control group were examined by immune histochemistry ABC technique in renal tissue.Results Plasma levels of IL-13 in patients with MsPGN were significantly higher than that in control group,and the highest was found in IgAN;IL-13 expressions in glomerulus and tubulointerstitial zone in patients with MsPGN were higher than that in control group, and IL-13 expression in tubulointerstitial zone was more strong,but it was not distinctive difference between non-IgA MsPGN and IgAN. Conclusion IL-13 may play an important role in the molecular pathogenesis of MsPGN.

Objective To investigate the effects of benazepril on urinary excretion of endothelin 1(Et 1) and the level of plasmic Et 1 (PEt) in patients with diabetes mellitus (DM) and diabetic nephropathy(DN).Methods PEt and 24 hours urinary excretion of Et 1 (UEtV) in 54 patients with DM and 39 patients with DN before and after taking benazepril (7.5～12.5mg/d) for two months were measured using radioimmunoassay method.Results PEt and UEtV in patients with DM were significantly higher than in normal control group ( P