AIM:To set up a method for determining epimedin C and icariin in Xianling Guobao Capsules(Herba Epimedii,Radix et Rhizoma Salviae miltiorrhizae,Fructus Psoraleae,Radix Rehmanniae,etc.). METHODS:The chromatographic conditions included the column of Spherisorb C 18 (4.6 mm?250 mm,5 ?m),the mobile phase was acetonitrice and water as gradient eluent was at a flow rate of 1.0 mL/min,the detection wavelength was set at 270 nm and the column temperature was at 25 ℃. RESULTS:The linear range of epimedin C was 0.22-2.20 ?g and icariin was 0.04-0.40 ?g,respectively. The average recovery of epimedin C and icariin were 103.2% (RSD=3.1%) and 97.8% (RSD=3.2%),respectively. CONCLUSION:The method is reliable,stable and well reproducible,and can control the quality of Xianling Guobao Capsules.

Objective To explore the role of clinical pharmacist in individualized treatment of hypertension.Methods A patient withH hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed.Results Patient's MTHFR (C677T) gene type was TT homozygous.Clinical pharmacist suggested doctor modify treatment,and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1,and blood pressure dropped from 173/ 111 mmHg(1 mmHg =0.133 kPa) to 130/80 mmHg.Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.

OBJECTIVETo investigate therapeutic effects of vacuum sealing drainage (VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.

METHODSFrom October 2007 to February 2011, 397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years (ranging age from 20 to 73 years). According to AO classification, 74 feet were type I, 211 feet were type II, 108 feet were type III and 19 feet were type IV. The mean time from injury to operation was 5.6 h ( 2 to 12 h). The mean treatment time of was 10 months (4 to 19 months).

RESULTSOne hundred and forty-one patients were primarily healed, 97 patients were sutured at stage II. Split-thick skin grafting was performed at stage II was performed in 103 patients; free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure; Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months (averaged 10 months). The wounds healed well.

CONCLUSIONVSD for soft tissue defects caused by ankle injury is a simple and effective method, but can not replace debridement and transfer flap.

Adult ; Aged ; Ankle Fractures ; Debridement ; Drainage ; methods ; Female ; Humans ; Joint Dislocations ; surgery ; Male ; Middle Aged ; Skin Transplantation ; Treatment Outcome ; Vacuum ; Young Adult

Objective To investigate the effects of Houpupaiqi mixture on the recovery of gastrointestinal function after open gastrointestinal surgery,and evaluate the efficacy and safety of Houpupaiqi mixture.Methods A total of 144 selected patients who underwent open gastrointestinal surgery were enrolled into the multi-center prospective randomized double-blind controlled clinical trial from October 2010 to September 2011.Of the 144 patients,66 were from People's Hospital of Peking University,72 were from Beijing Friendship Hospital of Capital University of Medical Sciences,and 6 were from People's Hospital of Guangdong Province.All the patients were randomly divided into 2 groups (test group:96 patients,control group:48 patients) at the ratio of 2∶1 according to the random number table.Five patients who did not meet the criteria were excluded from the study,and then there were 92 patients in the test group and 47 patients in the control group.The study was assessed by the ethics committees,and all the patients signed the informed consent form.Houpupaiqi mixture (50 ml) or placebo (50 ml) were administered in the test group and control group at postoperative 16 and 20 hours,respectively.Parenteral and enteral nutritional support were given after pulling out of gastric tube.A standard intravenous analgesia was applied in the 2 groups,and agents which stimulate or suppress gastrointestinal motility were prohibited.The time for the recovery of regular bowel sounds,the first exhaust and first defecation time,and the time of first solid food intake of the 2 groups were recorded.Vital signs were recored before operation and after drug administration.Blood and urinary routine test,hepatic and renal function test,electrocardiogram examination,record of adverse drug event were carried out at postoperative day 6.The time for the indexes above and relevant frequencies were calculated,and the survival curve were drawn by Kaplan-Meier method.All the time points were analyzed using the Log-rank test.The measurement data were analyzed using the t test or rank-sum test,and the enumeration data were analyzed using the chi-square test or Fisher exact probability.Results The median time for the recovery of regular bowel sounds,median time for first exhaust and defecation were 21.4 (20.0,23.7)hours,45.0 (40.0,54.0) hours and 65.5 (54.7,74.0) hours in the test group,and 47.5 (44.0,56.5) hours,91.0 (87.0,93.8)hours,98.0 (94.0,113.5)hours in the control group,there were significant differences between the 2 groups (Log-rank values =21.67,53.15,11.81,P＜0.05).The median time of first solid food intake were 72.5 (66.2,110.5) hours of the test group and 116.3 (114.8,117.3) hours of the control group,with no significant difference between the 2 groups (Log-rank value =13.70,P ＞ 0.05).There were no significant differences in the body temperature,respiration,heart rate,systolic blood pressure and diastolic blood pressure before and after medication between the 2 groups (Z =0.03,0.68,0.97,0.22,0.72,P ＞ 0.05).There were no significant differences in the number of patients with abnormal results of blood test,hepatic function,renal function and electrocardiogram between the 2 groups (P ＞ 0.05).No severe adverse event was observed in the clinical trial.Conclusion Houpupaiqi mixture significantly promotes the recovery of gastrointestinal function of the patients who underwent open gastrointestinal surgery with relatively low adverse events.

Objective To evaluate the clinical effects and experiences of short stem ceramic-on-ceramic total hip arthroplasty in the treatment of young and middle-aged patients with femoral head necrosis.Methods From December 2009 to March 2011,40 patients with femoral head necrosis were treated primarily with short stem ceramic-on-ceramic hip arthroplasty (43 hips) through posterior-lateral or anterior-lateral approach.There were 23 males,17 females； with the mean age of 40.5 years (range,27-55 years).All cases were stage Ⅳ or more according Steinberg stage.The patients were followed up at the 3,6,12 months after operation,and then once each year.Standard X-ray films were taken at the follow-ups.Femoral prosthesis subsidence was assessed through X-ray films.Harris scores system and WOMAC Osteoarthritis Index were recorded before and after operation to evaluate clinical effects of surgery.Results Thirty-eight patients (41 hips) were followed up for 21-36 months,with an average of 31.3 months.The femoral stem subsided 0.68±2.90 mm at the last follow-up.After operation,hip pain of patients was relieved obviously.The Harris score improved from 38.7±12.1 (15-66) preoperatively to 95.2±4.49 (83-100) postoperatively,WOMAC Index from 66.7±12.0 (49-94) to 12.8±5.6 (0-24).During follow-up period,there was no serious complication such as femoral neck fracture,infection of wound,pulmonary embolism,et al.No dislocation,implant prosthesis failure and infection were observed.Conclusion The short stem hip arthroplasty preserves bone stock to a great extent.The short stem implant showed a good stability and osseous integration.The wear rate of ceramic-on-ceramic bearing surface is extremely low.Short stem hip arthroplasty plus ceramic-on-ceramic bearing surface might be a good option for the young and middle-aged patients with femoral head necrosis.

Objective To evaluate the clinical indications and outcomes of dynesys neutralization system in the treatment of degenerative lumbar diseases.Methods From January 2007 to December 2011,102 consecutive patients with degenerative lumbar spine diseases underwent posterior decompression and internal fixation with the Dynesys dynamic neutralization system.Among them,69 patients were followed up,including 39 males and 30 females,aged from 30 to 62 years (average,44 years).The series of cases were composed of 24 cases of lumber disc herniation,35 cases of degenerative spinal stenosis,10 cases of degenerative changes of lumbar discs.Results The mean follow-up period was 35 months (range,6-44 months).The visual analogue scale (VAS) score decreased from preoperative 8.6 (range,6-9) to postoperative 2.8 (range,0-5),and the Oswestry disability index (ODI) improved from preoperative 73％ (range,30％-91％) to postoperative 30％ (range,0-61％).There were no implant failure or infection.According to the evaluation criteria of surgical treatment for low back pain,which was established by the Chinese Orthopaedic Association,the result was excellent in 53 patients,good in 12 patients,fair in 4 patients and poor in 1 patient.Conclusion The Dynesys dynamic neutralization system is effective in the treatment of degenerative lumbar spine disease,which can reserve the range of motion of stabilized segments,prevent degeneration of adjacent segments and improve clinical outcomes.

Objective To evaluate the clinical efficacy of total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe Ⅳ developmental dysplasia of the hip.Methods From September 2003 to September 2012,21 patients (24 hips) underwent total hip arthroplasty with subtrochanteric femoral shortening osteotomy for Crowe Ⅳ developmental dysplasia of the hip in our hospital.There were 3 males and 18 females,aged from 28 to 71 years (average,54±10 years).The ceramicpolyethylene articulation was used in 17 patients (20 hips),and metal-polyethylene articulation in 4 patients (4 hips).The osteotomy site was treated with autologous bone graft in 18 patients (21 hips) and allogeneic bone graft in 3 patients (3 hips).The Harris hip score was used to assess the clinical results.Results A total of 18 patients were followed up for 0.5 to 9 years (average,3.5 years).The Harris hip score was improved from preoperative 47.9±9.1 to 88.4±3.5 at 6 months postoperatively.For most patients,hip pain relieved significantly; range of motion of the hip was improved,and the gait returned to normal.Sciatic nerve palsy occurred in 1 patient.There was no wound infection.X-rays 6 months after operation showed that the position of prostheses was satisfactory,without loosening of prostheses and bone block resorption.Conclusion Total hip arthroplasty with subtrochanteric femoral shortening osteotomy can achieve good clinical effect in Crowe Ⅳ developmental dysplasia of the hip.Moreover,it can improve leg length discrepancy and decrease the risk of sciatic nerve injury.

Objective To retrospectively analyze the methods and clinical outcome to treat Crowe type Ⅳ developmental dysplasia of the hip (DDH) in young adults with total hip arthroplasty (THA) after limb-lengthing with external fixator.Methods From October 2007 to January 2012,12 patients with unilateral Crowe type Ⅳ DDH were treated with two-staged surgical method in our department.There were 2 males and 10 females with an average age of 25.7 years (range,18-35 years).In the first stage,the patients underwent soft tissue relaxation and iliofemoral distraction with use of an external fixator for 10-17 days.There were 1-2 cm distraction at the first time and 3-5 mm daily distraction.When the femoral head was distracted to the level of anatomical position,the second stage-THA was performed.All patients underwent uncemented prosthesis with bulk femoral head autograft for acetabular reconstruction.The acetabular cup was placed in the anatomical position in every patient.Shortening femoral osteotomies were not required.Results The mean time of first operation was 35.2±3.6 min,and hospital stay was 13.3±1.6 days.The mean time of second operation was 77.3±12.4 min,and hospital stay was 9.2±2.5 days.The average follow-up was 13.6±3.2 months,limb-length discrepancy was 5.6±1.5 cm on average preoperatively and 0.5±0.2 cm on average postoperatively.The Harris hip score was increased from 45.7±2.6 preoperatively to 92.3±3.3 postoperatively.All of the cases had acquired good hip and knee function.No patient suffered pin-site infection,hip joint infection,prosthesis loosening or deep vein thrombosis in our research.Transient nerve palsy occurred during the leg limb lengthening in 3 cases; calf skin numbness after THA occurred in 5 cases.Conclusion For the Crowe type Ⅳ DDH in young adults,normal limb length can be restored nearly and avoid nerve injury via continuously limb-lengthing with external fixator before THA.This method can get precise results,improve limb function significantly and have fewer complications.

Brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) are important biomarkers for pediatric cardiovascular diseases. Peptide levels are associated with age and gender. Current studies have shown that BNP and NT-proBNP are valuable in the diagnosis of heart failure, with a high specificity and sensitivity. They also contribute to differentiating heart failure from acute respiratory distress induced by simple pulmonary factors. In addition, BNP and NT-proBNP are useful in the evaluation of disease severity and treatment guidance in children with pulmonary hypertension, cardiomyopathy and Kawasaki disease. Current limitations include the relatively small sample size of the study, the detection method and a range of normal values that are not completely uniform.
Cardiomyopathies ; diagnosis ; Cardiovascular Diseases ; blood ; diagnosis ; Child ; Dyspnea ; diagnosis ; Familial Primary Pulmonary Hypertension ; Heart Failure ; diagnosis ; Humans ; Hypertension, Pulmonary ; diagnosis ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood

Objective To investigate the effects of zoledronic acid on the expression of HIF-1α and VEGF in osteosarcoma LM8 cell line under hypoxic condition. Methods The hypoxic culture model was established. After LM8 cells were treated with zoledronic acid, semi-quantitative PCR was used to assess the expression of HIF-1α and VEGF mRNA. The expression of HIF-lct and VEGF protein was de-tected by immunohistochemical staining and ELISA respectively. Results Compared with cells in normoxic conditions, cells in the hypoxic environment and cells treated with zoledronic acid in the hypoxic condition did not show a significant change in the mRNA level of HIF-1α(P >0. 05). However, the protein expression of HIF-1α was markedly decreased in the cells treated with zoledronic acid in the hypoxic envi-ronment. In contrast, both mRNA and protein expression levels of VEGF were down-regulated in the zoledronic acid treatment hypoxic group (P <0.05). Conclusion Under hypoxic conditions in vitro, zoledronic acid inhibited the expression of HIF-1α protein, which decreased VEGF mRNA level and protein expression in osteosarcorna LM8 cell line.