Objective To assess the usefulness video-assisted mediastinoscopy (VM) for diagnosis of disease characteristic with mediastinal mass. Analyze the correlations of clinical features of the disease with the pathologic diagnosis. Methods Between July 2000 and March 2006, 97 undiagnosed patients with mediastinal mass in chest radiography underwent biopsy of mediastinal lesions by either cervical mediastinoscopy (n=69) or parasternal mediastionoscopy (n=28). We also analyzed the correlation of symptoms, location and extent of the lesion with the pathologic diagnosis. Results All 97 patients recovered smoothly without postoperative complications. Histologic diagnosis was obtained in 96 patients. Patients with hoarse, dysphagia and superior vena cava obstruction syndrome indicate malignant lesions (26/26). The most common diseases in the super-anterior mediastinum are lymphoma(7/19), thymoma(4/19) and small cell lung cancer(SCLC) (4/19);The most common disease in the middle mediastinum are metastasis of non small cell lung cancer(11/37), sarcoidosis (9/37)and SCLC(7/37); The most possible disease involved both mediastinum and lung hilar lymph-node are scalerdosis(32/41) and SCLC(5/41). Conclusion Mediastinoscopy is effective and safe methods to establish a histologic diagnosis in patients with mediastinal mass. It is possible to make primary evaluation on some of these patients according to the typical symptoms and location, extent of the mass involvement.

OBJECTIVE:To optimize the formulation of Compound tripterygium hypoglaucum gel. METHODS:Using the comprehensive score(total score was 15.0)composed by forming property,glossiness,uniformity,viscosity,pH,spreadable prop-erty and stability as indexes,using the usage amount of carbomer 940,propylene glycol,triethanolamine and extracts in formula as study factors,orthogonal test was designed to optimized the formulation of Compound tripterygium hypoglaucum gel,and the verification test was conducted. RESULTS:The optimal matrix formulation was as follow as carbomer 9401.0 g,azone 2.0 g,so-dium bisulfite 0.4 g,extracts 50 mL,propylene glycol 10 g,triethanolamine 1.0 g,adding water to 100 g. The average comprehen-sive score of the gel in verification test was 14.8 (RSD=1.35%,n=3). CONCLUSIONS:The optimized formulation of Com-pound tripterygium hypoglaucum gel shows good forming property,the quality meets the requirements.

Aim The metabolic character of neferine(Nef) in rat liver microsomes was studied in vitro to identify which isoforms of cytochrome P450 were responsible for Nef metabolism in rats.Methods ① Wistar rats were untreated or treated with various inducers including dexamethasone(DEX,50 mg?kg~(-1),ig?4 d),phenobarbital(PB,75 mg?kg~(-1),ip?3 d) and ?-naphthoflavone(?-NF,80 mg?kg~(-1),ip?3 d).Liver microsomes were obtained from these rats and incubated with Nef in the presence of reduced form of nicotinamide adenine dinucleotide phosphate.A HPLC-UV method was developed to determine Nef and its metabolites.② The enzyme kinetics of the metabolism of Nef was investigated in rat liver microsomes.③ Troleandomycin,a CYP3A selective inhibitor,was used to study its inhibitory effect on the metabolism of Nef in vitro.Results ① The metabolism of Nef in rat liver microsomes showed the characteristic of enzymekinetics.② The correlation between peak area of a metabolite and original concentration of Nef in rat liver microsomes solution was significant(r=0.993).③ The disappearing rate of Nef in the incubation solutions of the rats liver microsomes,which treated with DEX or PB,were markedly quicker than that of control group(P0.05).The average disappearing rates of Nef in rat liver microsomes after incubation with different inducers were as follows: DEX,80.6%?9.5%;PB,61.5%?6.7%;?-NF,20.7%?1.5%;Control,19.9%?1.6%.④ Troleandomycin could significantly inhibit the metabolism of Nef in rat liver microsomes.Conclusion Our results suggest that both CYP3A and CYP2B are involved in Nef metabolism in rats liver microsomes,and CYP3A probably play a major role.

AIM: To study the linear relationship between pharmacokinetic parameters and doses about potassium clavulanic acid (CAV) and amoxicillin (AMX). METHODS: 15 healthy male volunteers were randomly divided into 5 dose groups. The plasma concentration of CAV and AMX was determined by high performance liquid chromatography (HPLC) method. The pharmacokinetic parameters obtained with 3p97 soft were regressed to corresponding dose. RESULTS: The regression equations of AUC and c max to dose about CAV were Y= 2.0895 X+ 0.4438 (r= 0.9915 ) and Y= 0.9397 X+ 0.1796 (r= 0.9922 ), respectively. The regression equations of AUC and c max to dose about AMX were Y= 4.8795 X+ 2.4794 (r= 0.9988 ) and Y= 1.7276 X+ 1.4832 (r= 0.9935 ), respectively. CONCLUSION: There is good linear relationship between pharmacokinetic parameters and doses about CAV and AMX.

Both pretreatment of lignocellulose and its saccharification process are treated with ultrasonic wave.The morphology,structure and crystal performance of the original and treated lignocellulose sample were characterized by SEM and FTIR.Moreover,the changes of raw materials caused by different pretreatment ways and the affect of saccharification rate brought about by ultrasonic wave were also studied.The result shows that the ultrasonic wave decreases the crystallinity of lignocellulose destroying the intermolecular hydrogen bonding effectively and improves the degradation rate of lignin and the saccharification rate of zymohydrolysis availably.The mechanism of activation of ultrasonic wave in zymohydrolysis process was discussed primarily.

Objective To apply the microbial transformation to transforming the total saponins in the fruit of Panax ginseng (SFPG) and preparing ginsenoside compound K (C-K). Methods The four microbial strains m14, m3, m8, and m9 were screened and isolated from the soil in the botanic garden planted for P. ginseng and they were used for the microbial transformation of SFPG to optimize the strains. Taking C-K contents as index the microbial transformation was detected and analyzed by TLC and HPLC. Results The strain m14 was found to transform the SFPG efficiently to C-K at first. The optimal culturing and transformation conditions of m14 were obtained: time, 6 d; temperature, 30 ℃; revolution of cradle, 160 r/min; initial pH value, 5.5; substratum concentration, 120 mg/mL. Under the optimal condition, the content of C-K was 41.65 times as much as before transformation by m14. Conclusion The m14 is the most effective strain among the four fungal strains. It is the new way available for the C-K industrialized production.

BACKGROUND:Because of osteoporosis, short-segment transpedicular fixation or screw-rod system fixation is prone to screw loosening depending on its poor anti-pul-out strength in patients with thoracolumbar fracture with ankylosing spondylitis.
OBJECTIVE:To probe the clinic outcomes of multi-segment transpedicle spinal fixation for thoracolumbar fractures with ankylosing spondylitis.
METHODS:Eleven patients with ankylosing spondylitis combined with thoracolumbar fracture in the Fourth Department of Orthopedics, Meizhou Hospital, Sun Yat-sen University, China from January 2009 to December 2012 were selected. Al the patients underwent posterior reduction and multi-segment transpedicle spinal fixation, among whom, six cases were subjected to internal fixation through the pedicle of fractured vertebra.
RESULTS AND CONCLUSION:Al of the 11 patients were fol owed up for 13 to 36 months. Solid bone healing was achieved in al of the patients, and there were no complications related to the internal fixation systems such as loosening or breakage. Three cases of spinal cord injury achieved Frankel’s class E from class C recovery. Lumbodorsal pain rate achieved 100%according to the Japanese Orthopaedic Association scoring. Results confirmed that it is effective to treat thoracolumbar fractures with ankylosing spondylitis by posterior reduction and multi-segment transpedicle spinal fixation. Strong internal fixation and fracture union can be achieved by operation.

Objective To evaluate preliminary effect of In-Space percataneous interspinous spacer in the treatment of lumbar instability.Methods Data of 18 patients who had undergone interspinous spacer implant for lumbar instability from May 2009 to June 2011 were retrospectively analyzed.There were 10 males and 8 female,aged from 39 to 58 years.All patients suffered from varying degrees of lower back pain induced by lumbar hyperextension,as well as radiating and segmental pain of unilateral lower limb.The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate clinical outcomes.The pre-and postoperative interspinous distance,trailing edge height of intervertebral space,foraminal width,foraminal height,segmental lordotic angle and lumbar range of motion were tested and compared.Results All patients were followed up for 18 to 36 months.The VAS score improved from preoperative 7.9±2.1 to 3.1±1.3 at 6 months postoperatively and 1.5±0.8 at final follow-up.The ODI improved from preoperative 82.1％±13.1％ to 54.7％±14.8％ at 6 months postoperatively and 10.1％±2.5％ at final follow-up.The postoperative interspinous distance,trailing edge height of intervertebral space,foraminal height,foraminal width,segmental lordotic angle and lumbar range of motion were 9.29±1.43 mm,11.28±0.85 mm,21.27±1.01 mm,10.83±0.73 mm,7.62°±0.74° and 6.34°±0.81°,respectively.Wound healed smoothly in all patients,and there were no complications such as spinous process fracture,spinal cord injury,cerebrospinal fluid leakage,device displacement and device dislocation.Conclusion It is easy and safe to use In-Space percataneousinterspinous spacer in the treatment of lumbar instability,and the preliminary effect is satisfactory.

Objective To evaluate the diagnostic value of the early rheumatoid arthritis (RA) classification criteria for early RA and to assess the clinical efficacy of knee arthroscopic synovectomy for RA.Methods A total of 62 patients who had arthritic complaints with disease duration less than one year were treated with knee arthroscopic synovectomy.Patients were diagnosed as RA confirmed by changes of synoviomorphous under arthroscopy,synovial biopsy,immunological biochemical laboratory and MRI,and compared with the preoperative ERA diagnosis.The efficacy was assessed at the third months and more than 12 months after operation,including Health Assessment Questionnaire (HAQ),Lysholm score,laboratory parameters of erythrocyte sedi-mentation rate (ESR) and C-reactive protein (CRP).Results The sensitivity and specificity in the early RA classification criteria for RA diagnosis were 81.58％ and 91.67％.38 patients diagnosed as RA and the remaining 24 patients were significantly improved of HAQ,Lysholm score,ESR,CRP compared with preoperation,showed statistical difference (P ＜ 0.01).There were still statistical differences between the follow-up results of the group of patients with RA in different period after operation (P ＜ 0.01).Conclusion The early RA classification criteria is worthy of clinical application,because it has the advantages of simple,practical,and is beneficial to early diagnosis of RA.The early RA patients should be treated with knee arthroscopic synovectomy as far as possible.It can improve not only the knee function,but also the general symptoms,and it can interrupt the RA pathological process,effective maintain curative effect after operation.

Objective　To evaluate the effect of occupation al protection measures on reducing blood exposure. Methods　A s urvey was carried out to investigate medical staff in Shanghai hospitals. Sing le-factor and multi-fa ctor analysis measures were used. Results　The more protection m eas ures adopted, such as gloves using, occupational training and strict rules and r egulations, the less occupational exposure. The resul ts also showed that there were statistical difference. Conclusions　It is important for medical staff to strength occupational protection in order to avoid acqu iring hospital infection.