A reversed phase high performance liquid chromatographic ( RP-HPLC ) method was proposed by using C18 column tandem crown ether chiral column for simultaneous separation of three kinds of aromatic amino acid enantiomers. The chromatographic conditions, including mobile phase proportion, pH, column temperature and flow rate, were optimized. The experimental results showed that the three aromatic amino acid enantiomers could be successfully separated under the optimal conditions such as perchloric acid solution-acetonitrile ( 86:14, V/V, pH = 2 ) as mobile phase, column temperature of 20℃ and flow rate of 0. 4 mL/min. The separation under four HPLC column connection modes was further investigated. The results revealed that different kinds of amino acids could be separated on C18 column, but not for amino acid enantiomers; amino acid enantiomers could be separated on crown ether chiral column, but the chromatographic peaks of each amino acid enantiomers overlapped seriously; baseline separation of three amino acid enantiomers could be obtained under the connection of two columns, but the separation under different column connection sequence almost had no difference except the peak shape.

Objective: To evaluate the effectiveness of nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid perilunate dislocation. Methods: Between September 2011 and October 2018, 17 patients with trans-scaphoid perilunate dislocation were treated with nitinol memory alloy two foot fixator and Kirschner wire. There were 12 males and 5 females, with an average age of 32.6 years (range, 23-52 years). The disease duration was 8 hours to 9 days, with an average of 6.5 days. The causes of injury included 6 cases of falling injury, 4 cases of traffic accident injury, 3 cases of stress injury of wrist caused by sports, 2 cases of violent injury of wrist caused by machine impact, 1 case of military training injury, and 1 case of other injury. One case was complicated with nerve injury. According to Herbert's classification, all the fractures were type B4. At 1 week before operation, 3 months, 6 months after operation and last follow-up, the wrist function was evaluated according to the Krimmer scale score. Results: All the 17 patients were followed up 10.5-48 months, with an average of 18.6 months. There was no loosening or infection of the internal fixator, no necrosis of the scaphoid and lunate. The periosteal dislocations of the patients were well reduced and the scaphoid fractures all healed. The healing time was 4-18 months, with an average of 11.3 months. The Krimmer wrist scores were 37.5±4.4, 61.3±7.2, 83.3±9.3, 87.3±8.2 at 1 week before operation, 3 months, 6 months after operation and last follow-up, respectively. The Krimmer wrist score at each time point after operation was significantly improved when compared with that before operation ( P<0.05), and at 6 months after operation and last follow-up than at 3 months after operation ( P<0.05). There was no significant difference between at 6 months and last follow-up ( P>0.05). At last follow-up, the Krimmer wrist function was excellent in 13 cases, good in 2 cases, fair in 1 case, poor in 1 case, and the excellent and good rate was 88.23%. Conclusion: Nitinol memory alloy two foot fixator combined with Kirschner wire in the treatment of trans-scaphoid periosteal dislocation has definite effectiveness, simple operation, and good recovery of wrist function after operation.

Objective: To provide anatomical basis for vascularized pisiform transfer in the treatment of advanced avascular necrosis of the lunate (Kienböck's disease) by studying its morphology and blood supply pattern based on digital technique. Methods: Twelve adult fresh wrist joint specimens were selected and treated with gelatin-lead oxide solution from ulnar or radial artery. Then the three-dimensional (3D) images of the pisiform and lunate were reconstructed by micro-CT scanning and Mimics software. The morphologies of pisiform and lunate were observed and the longitudinal diameter, transverse diameter, and thickness of pisiform and lunate were measured. The main blood supply sources of pisiform were observed. The number, diameter, and distribution of nutrient foramina at proximal, distal, radial, and ulnar sides of pisiform were recorded. The anatomic parameters of the pedicles (branch of trunk of ulnar artery, carpal epithelial branch, descending branch of carpal epithelial branch, recurrent branch of deep palmar branch) were measured, including the outer diameter of pedicle initiation, distance of pedicle from pisiform, and distance of pedicle from lunate. Results: There were significant differences in the longitudinal and transverse diameters between pisiform and lunate ( t=6.653, P=0.000; t=6.265, P=0.000), but there was no significant difference in thickness ( t= 1.269, P=0.109). The distal, proximal, radial, and ulnar sides of pisiform had nutrient vessels. The nutrient foramina at proximal side were significantly more than that at distal side ( P<0.05), but there was no significant difference in the diameter of nutrient foramina between different sides ( P>0.05). The outer diameter of pedicle initiation of the recurrent branch of deep palmar branch was significantly smaller than the carpal epithelial branch and descending branch of carpal epithelial branch ( P<0.05). There was no significant difference in the distance of pedicle from pisiform/lunate between branch of trunk of ulnar artery and recurrent branch of deep palmar branch ( P>0.05), and between carpal epithelial branch and descending branch of carpal epithelial branch ( P>0.05). But the differences between the other vascular pedicles were significant ( P<0.05). Conclusion: There are abundant nutrient vessels at the proximal and ulnar sides of pisiform, so excessive stripping of the proximal and ulnar soft tissues should be avoided during the vascularized pisiform transfer. It is feasible to treat advanced Kienböck's disease by pisiform transfer with the carpal epithelial branch of ulnar artery and the descending branch.

Objective To analyze the incidence and related risk factors of hyperuricemia after liver transplantation.Methods A total of 286 cases undergoing liver transplantation from 2009 to 2012 in the Armed Police General Hospital , who had normal uric acid before transplantation and had been followed up for more than 1 year, were enrolled in this study.The clinical data, including liver and kidney function , blood glucose, and lipids were collected .The potential risk factors of hyperuricemia were analyzed .Results 53.5% cases ( 153/286)had hyperuricemia after transplantation.Hyperuricemic patients were predominately older (P =0.038). They also had a higher prevalence of increasing creatinine (P=0.000),and hyperlipidemia(P=0.000).Among female cases, hyperuricemic patients had a higher average BMI (P=0.027).Hyperuricemia group had an elevat-ed ratio of blood lipids 60.1%(92/153), higher than normal uric acid group (39.1%,52/133) ( P<0.05). Conclusions Liver transplantation recipients have a higher incidence of hyperuricemia , particularly in elderly and overweight female patients .Our findings suggest that postoperative hyperuricemia may be associated with high serum creatinine, elevated blood lipids.We should strengthen follow-up, take early detection and early treat-ment.

Objective To compare the clinical effects of HC video laryngoscope and fiberoptic bronchoscope (FOB)in guidance of endotracheal intubation for patients undergoing cervical surgery.Meth-ods A total of 50 patients (ASA I or II)with cervical vertebra injury,nerve root cervical spondylopathy or cervical spondylotic myelopathy in the first affiliated hospital of Wenzhou medical university were selected, all of whom were undergone selective cervical operations between March 2014 and June 2015.The patients were randomly divided into two groups (n =25):HC video laryngoscope group (group H)and FOB group (group F).After induction of anesthesia,HC video laryngoscope and FOB were used for tracheal intuba-tion.⑴ Intubation time and success rates of intubation were recorded,and visual analogue scale (VAS) was used to evaluate the difficulty of intubation;⑵ Mean arterial pressure (MAP),heart rate (HR),and rate-pressure product (RPP)before incubation (Tb),immediate after intubation (T0),and 1min after in-cubation (T1)were recorded;(3)Intubation-related complications were recorded.Results ⑴ The dura-tion of intubation (19.7 ±7.1 )s in the group H was significantly shorter than that of group F (51.9 ± 19.2)s (P <0.05).The one-time success rate of intubation in group H (92%)was higher than that of group F (64%),with statistically significant differences (P <0.05).Intubation was easier in group H (P <0.05).⑵ MAP,HR and RPP of group H at T0 were higher than those of group F.And at T1,there were no statistical differences between groups in MAP,HR and RPP (P >0.05).⑶ The incidence of complications (sore throat)was lower in group H (P <0.05).Conclusions Compared to FOB,HC vid-eo laryngoscope-guided selective cervical operation has the characteristics of higher success rate of intubat-ion,shorter operation time,and easier operation,more stable hemodynamics and lower incidence of intuba-tion complications.Therefore,HC video laryngoscope is a safe and effective method in the intubation for pa-tients undergoing cervical surgery.

Objective To explore the effect of proprioceptive neuromuscular facilitation (PNF) on balance function of stroke patients in community. Methods 204 stroke patients in community were divided into control group (n=98) and observation group (n=106). The control group accepted routine rehabilitation and the observation group received PNF additionally. Fugl-Meyer Assessment of lower extremities (FMA), Berg Balance Scale (BBS) and static balance locator were used to evaluate the motor and balance function before and 3 months after treatment. Results The scores of FMA and BBS were higher after treatment than before (P<0.05) in both groups, and were higher in observation group than in control group (P<0.05). The length of path (L), covered area (A) and L/A were less in observation than in control group (P<0.05) both in the eye-open and eye-closed modes. Conclusion PNF can improve the lower extremities motor and balance function of stroke patients in community.

ObjectiveTo analyze the etiologies and diagnosis of jaundice after liver transplantation during mid later stage and summarize the experience of clinical practice.Methods822 liver transplantation patients were collected from the Department of Internal Medicine, Organ Transplantation Institute in General Hospital of Chinese People's Armed Police Forces between June 2005 and Dec.2008.The clinical data of these cases were analyzed retrospectively.ResultsAmongst 822 patients,129 experienced jaundice after liver transplantation and the occurrence of jaundice ranged from 43 days to 39 months postoperation.Total bilirubin levels were from 27.4 to 503 μmol/L.The etiologies of jaundice and its percentage were as follow:59 cases of biliary complications (45.7％),36 of rejection (27.8％ ),11 cases of virus infection (8.5％),5 cases of drug-induced hepatic injury (3.9％),4 cases of tumor recurrence (3.1％),4 cases of Gilbert syndrome (3.1％),3.cases of dysfunction of papillary muscle (2.3％),2 cases of vascellum complication (1.6％),2 cases of radiation hepatitis (1.6％),1 case of hepatapostema (0.8％),2 cases of unknown reasons (1.6％),respectively.The jaundice of most patients (93％) got released while small part of patients (7％)failed to treatment,of whom 5 cases received liver re-transplantation and 4 cases died of disease progression.ConclusionThe etiologies of jaundice after liver transplantation during mid-later stage are diversiform and complex.And the etiological diagnosis is the premise to treat effectively.

Objective To evaluate the efficacy and safety of glargine combined with repaglinide in the treatment of post-transplantation diabetes mellitus(PTDM).Methods PTDM patients who were treated in our hospital from Jan 1,2010 to Dec 31,2010 were enrolled in this study.They were administrated with glargine combined with repaglinide for 6 months,and their glucose level,hepatic and renal function indicators,and tacrolimus concentration were examined at baseline and 1,3,and 6 months after treatment.Results Totally 44 patients were included and given dietary control.Three cases were not given any hypoglycemic drugs,7 were administrated with glargine only,30 cases received glargine combined with repaglinide therapy,and 4 cases required intensive insulin therapy.All the patients achieved satisfactory glycemic control.The hepatic function,renal function,and serum tacrolimus concentration showed no significant change before and after repaglinide therapy(P ＞ 0.05).Five hypoglycemic events were recorded during the treatment,in which the lowest blood glucose level was 3.7 mmol/L.No severe hypoglycemia happened.Conclusion On the basis of dietary control,glargine combined with repaglinide provides a safe and effective therapy for PTDM.

To summarize and explore the etiopathogenisis, clinical 'characteristics, diagnosis and treatment and prognosis of idiopathic adulthood ductopenia. We described a 27-year-old Chinese female initially manifested with jaundice, pruritus, dark urine, and pallor of the stools in October, 2002. Symptoms occurred repetitively and severed progressively, and she received therapy at the General Hospital of Chinese People's Armed Police Forces. B-ultrasound demonstrated that hepatic lesion and slightly swelling spleen. Pathological diagnosis of liver biopsy showed that she affected idiopathic adulthood ductopenia. The outcome of treatment of ursodeoxycholic acid and adrenal cortical hormone was not significant. She received orthotopic liver transplantation on June 24~(th), 2005. After liver transplantation, pruritus and jaundice were promptly disappeared. Each index of hepatic function recovered to a normal level. In March 2007, decreased dose of hormone induced an abnormal hepatic function, with mildly acute rejection. Drug dose was regulated, and hepatic function gradually returned to normal. During follow-up 51 months after the operation, she was doing well and was free of symptoms with normal liver function and no evidence of allograft dysfunction. The pathogenesis of idiopathic adulthood ductopenia is still unknown. There are still no precise and effective drugs for treatment of idiopathic adulthood ductopenia. Liver transplantation offers an effective therapy for end-stage patients with idiopathic adulthood ductopenia.

Objective To investigate the effects of repetitive ultraviolet A(UVA) radiation on the endocytosis and intracellular degradation of extracellular elastin by human dermal fibroblasts(HDFs), and to explore the mechanism responsible for elastin accumulation in photoaging skin. Methods Cultured HDFs were divided into two groups:repetitive UVA radiation group treated with UVA radiation(9.9 J/cm2)once a day for seven consecutive days to establish a chronic photodamage model, and blank control group receiving no treatment. For the verification of the model, flow cytometry was performed to detect cell cycle, and senescence-associated β-galactosidase staining to determine the degree of cell senescence. Fluorescent tracer technique and conjugated polymer-based fluorescence quenching technique were conducted to observe the endocytosis and intracellular degradation of extracellular elastin in culture media by HDFs in these groups. Results Compared with the blank control group, the repetitive UVA radiation group showed increased proportions of G1-phase cells and senescent cells, which confirmed the successful establishment of chronic photodamage model in the repetitive UVA radiation group. After coculture with elastin for 24, 48 and 72 hours, the endocytosis rate of elastin was 10.0% ± 1.4%, 27.8% ± 4.2% and 39.9% ± 4.1% respectively in the blank control group, 9.9% ± 1.6%, 28.3% ± 5.1% and 42.0% ± 5.7% respectively in the repetitive UVA radiation group, with no significant difference between the two groups at the three time points (all P > 0.05). The percentage of cells showing intracellular degradation of extracellular elastin was significantly lower in the repetitive UVA radiation group than in the blank control group (4.2% ± 1.1% vs. 7.7% ± 0.9% at 24 hours, 16.5% ± 2.4% vs. 22.8% ± 1.8% at 48 hours, 26.7% ± 2.6% vs. 33.9% ± 3.1% at 72 hours, all P < 0.05). Conclusions UVA radiation at 9.9 J/cm2 for 7 consecutive days can decrease the intracellular degradation of extracellular elastin by HDFs, but has no obvious effect on endocytosis of elastin.