AIM:To establish a HPLC method for determining contents of tetrahydropalmatine and pepper alkali in Zhitong Capsule(Rhizoma Corydalis,Fructus Piperis,Radix Paeoniae alba,etc.)to control its quality.METHODS:The samples were extracted in water by ultrasonic wave,and then extracted by aether to refine after being acidized by 1 mol/mL HCl.Following that the pH of water solution was adjusted to 9.0-10.0 by NH_3?H_2O,and then extracted by aether again.After that,the aether solution was collected to evaporation to dryness and metered by methanol.The sample solution was determined by high performance liquid chromatography on a Hypersil ODS 2 C_ 18 column(4.6 mm?250 mm,5 ?m)with mobile phase composed methanol-0.1% phosphoric acid water solution(the pH was adjusted to 6.0 by triethylamine)(55∶45).The flow rate was 1.0 mL/min,the column temperature was at 30 ℃ and the signal from 0 to 14.5 minutes were acquired at 280 nm,and that from 14.5 to 22 minutes were detected at 328 nm.RESULTS:The resolution of tetrahydropalmatine and pepper alkali was good,with no miscellaneous peak.The linear range was at 0.196-1.96 ?g(r=0.999 6)for tetrahydropalmatine,0.03-0.3 ?g(r=0.999 7)for pepper alkali.The average rate of recovery of tetrahydropalmatine was 97.74%(RSD= 0.42%,n=6),and that of pepper alkali was 104.51%(RSD=2.01%,n=6).CONCLUSION:The method is simple,reliable,accurate and can be applied to the quality control of the preparation.

Objective To observe the outcome of Nimodipine and Salvia Miltiorrhiza Composite in treating newborn hypoxic ischemic encephalopathy(HIE ) . Methods 128 HIE patients were randomly divided into four groups;-Salviae Miltiorrhiza Compsite treated group (n=32) , Nimodipine treated group (n 30) , Nimodipine plus Salviae Miltiorrhiza Composite treated group ( n =35) , and control group ( n =31) , in which the symptoms and signs , the reactions following treatment were observed .Results The total effective rates of Salviae Miltiorrhize Composite treated group , Nimodipine treated group , Nimodipine plus Salviae Miltiorrhiza Composite treated group were 81.3% (26/32) , 80% (24/30) and 97.1% (34/35) respectively , and the markedly effective rates were 53.1% (17/32) , 53.3% (16/30) and 88.6% (31/35) respectively . The total effective rates and the markedly effective rates of control group were 51.6% (16/31) and 6.5% (2/31) respectively ,the treated groups were higher than that of control group ( P

Objective Investigation and analysis of intelligence and psychomotor function in children born after implementingt universal salt iodization(USI). Methods Historical serious illness areas of water iodine below 10μg/L were selected as study sites, water iodine in 50 - 100 μg/L in the historical non-endemic areas were as control points in Henan, 2008. Cluster sampling was used to select children aged 6 - 15 years as observing subjects,IQ were measured with CRT- Man Test(CRT-C2). A "Tianjin Medical psychomotor test battery" (JPB) was carry out to test psychomotor function. Results In IDD regions 230 children were surveyed post-USI and 1284 children preUSI. The IQs post and pre USI were 99.3 and 99.9, respectively, and the proportion of IQ ≤69 were 2.17%(6/230) and 2.80%(36/1284), respectively. In non-IDD regions 650 children were surveyed post-USI and 2079children pre-USI. The IQs post and pre USI were 95.3 and 93.8, respectively, and the proportion of IQ ≤ 69 were 2.31%(15/650) and 3.37%(70/2079), respectively. In IDD regions, the abnormal rate of T scores and damage index post USI were 3.6%(2/56), 5.3%(3/56), respectively, significantly lower than pre USI [18.1%(29/160),18.1%(29/160), x2 = 7.54, 6.86, all P ＜ 0.01]. Conclusions USI could increase the IQs of children and decrease the positive rate of JPB, and significantly improve the quality of whole nation and persistently eliminating IDD.

Objective To introduce the processes of vascularized parathyroid gland reservation and parathyroid autotransplantation applied in thyroidectomy. Methods In 46 cases who underwent total/near total thyroidectomy, in situ vascularized parathyroid gland reservation was performed in 24 cases,isolated parathyroid autotransplantation was performed in 5 cases, in situ vascularized parathyroid gland reservation of 1～2 parathyroid glands combined with immediately transplantation of the remaining isolated parathyroid glands were performed in 17 cases. Results Five cases suffered from transient hypocalcaemia, including 2 cases of vascularized parathyroid gland reservation and 3 cases of vascularized parathyroid gland reservation in 1～2 parathyroid glands combined with immediately transplantation of other parathyroid glands. Two cases who received parathyroid autotransplantation suffered from hypocalcaemia and received conservative treatment with activated vitamin D3 and caleium for 4 weeks or 8 weeks. Permanent hypoparathyroidism occurred in 1 case of 46 cases which undergone the total/near total thyroidectomy(2.2%). Conclusion Application of vascularized parathyroid gland reservation and parathyroid autotransplantation in total/near total thyroidectomy could reduce the incidence rate of post-operative hypoparathyroidism.

Objective To investigate the mechanism of neural protection of mouse nerve growth factor combined with sub-hypothermia in the treatment of patients with severe traumatic brain injury. Methods 90 cases of severe traumatic brain injury were randomly divided into study group and control group with 45 cases of each group, the control group were given routine treatment; the study group were given on the basis of routine treatment of mouse nerve growth factor combined with sub-hypothermia treatment, with 2 weeks treatment, the clinical indicators and corresponding nerve injury, inflammation, oxidative stress indexes, clinical effect and complications were compared after 2 weeks treatment. Results Compared with before treatment or control group, scores of Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) and montreal cognitive assessment (MoCA) in study group after the treatment increased, National Institute of Health stroke scale (NIHSS) score decreased(P<0.05), neuronspecific enolase (NSE), myelin basic protein (MBP) and S100 beta levels decreased(P<0.05), the serum tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6), IL-10 levels decreased (P<0.05), the malondialdehyde (MDA) decreased, the glutathione peroxidase (GPx) and oxidation resistance (AOA) levels increased (P<0.05). The control group efficiency was 73.33%, the study group efficiency was 91.11%, there was significant difference (P<0.05). All patients were followed up, no case off, there was no significant difference in adverse drug reaction rate between two groups. Conclusion Mouse nerve growth factor and sub-hypothermia has the significant neural protection for patients with severe traumatic brain injury, and its mechanism may be related to reduce nerve injury indicators and improve inflammatory factor and oxidative stress response.

Objective: To establish a UPLC method for the simultaneous determination of benzoylmesaconitine, benzoylaconitine, benzoylhypaconitine, mesaconitine, hypaconitine and aconitinein Aconiti Lateralis Radix Praeparata (ALRP) and Aconiti Radix (AR), and to compare the content difference of six alkaloids in the samples with multivariate statistical analysis. Methods Alkaloids in ALRP and AR were extracted with 0.05 mol/mL hydrochloric acid solution by ultrasonic extraction. The UPLC method was performed on a BEH C18 (100 mm × 2.1 mm, 1.7 μm) through a gradient elution of acetonitrile and water at a flow rate of 0.1 mL/min with column temperature at 35 ℃. The injection volume was set at 4.0 μL, and the detection wavelength was set at 235 nm. Difference significance analysis, activity ratio analysis, toxic constituents index analysis, correlation analysis, hierarchical cluster heatmap analysis, principal component analysis, and TOPSIS analysis were used for data processing to comprehensively evaluate the quality of ALRP and AR. Results The method was in accordance with the regulations. Compared with the content of six alkaloids in ALRP and AR, significant difference existed in mesaconitine, benzoylhypaconitine, aconitine, and monoester diterpenoid alkaloids (MDAs); Significant difference existed in benzoylmesaconitine and benzoylaconitine; There were no significant difference in hypaconitine and diester-diterpenoid alkaloids (DDAs). Taking the six alkaloids as indexes, the sample No. 15 of ALRP was the best in quality and the samples No. 7 of AR was the best in quality. Conclusion The established method is simple, accurate and reliable with good precision, repeatability and stability, which can be used for the simultaneous determination of six alkaloids in ALRP and AR. It is much more accurate and convenient to conduct the quality evaluation by using activity ratio, toxic constituents index and multivariate statistical analysis. The study could provide a reference for improving analysis and determination of ester-type alkaloids in ALRP and AR in ChP, and providing a reference for quality control and evaluation of ALRP and AR.

Objective To establish a UPLC method for the simultaneous determination of uracil, adenosine, guanosine, and uridine in Aconiti Lateralis Radix Praeparata (ALRP) and Aconiti Radix (AR), and to compare the content difference of four nucleosides in the samples based on multivariate statistical analysis. Methods Nucleosides in ALRP and AR were extracted with purified water by ultrasonic extraction. The UPLC method was performed on a BEH C18 (100 mm × 2.1 mm, 1.7 μm) through a gradient elution of acetonitrile and water at a flow rate of 0.2 mL/min with column temperature at 30 ℃. The injection volume was set at 4.0 μL, and the detection wavelength was set at 260 nm. Difference significance analysis, hierarchical cluster heatmap analysis, principal component analysis, and TOPSIS analysis were used for data processing to comprehensively evaluate the quality of ALRP and AR. Results The method was in accordance with the regulations, the quantitative evaluation of uracil, adenosine, guanosine, and uridine was in good linear range (r2 > 0.999 3), and the average recovery was 99.86%, 99.14%, 99.74%, and 98.71% respectively, and the RSDs were all less than 2.0%. Taking the four nucleosides as indexes, the samples No. 18 of ALRP and the samples No. 23 of AR were the best in quality. Conclusion The established method is simple, accurate, and reliable with good precision, repeatability, and stability, which can be used for the simultaneous determination of four nucleosides in ALRP and AR, and it might provide the scientific basis for the study of water-soluble constituents in ALRP and AR.

BACKGROUND:Tantalum rod implant technology is a new method of early osteonecrosis treatment. Current research on stress distribution before and after tantalum rod implant in different sizes of femoral head necrosis area is few. OBJECTIVE:To analyze the stress distribution before and after tantalum rod implantation in different sizes of necrotic femoral head area using three-dimensional finite element method. METHODS:Three-dimensional finite element models of normal femoral head and necrotic femoral head of 15, 20 and 30 mm diameterwere constructed. Eight measuring points were chosen on two tiers of each necrotic model to detect the stress distribution and its alteration before and after tantalum rod implantation. RESULTS AND CONCLUSION:(1) Stress concentration werefound on every necrotic femoral head, most pronounced on the one with 30 mm lesion. (2) Tantalum implant appeared to reduce the stress concentration generaly. Comparison of the peak points of these models indicated most significant benefit in 15 mm lesion, next in 30 mm lesion, last in 20 mm lesion. (3) Results indicate that larger lesion entails more concentrated stress distribution and more likely to colapse. Tantalum rod implantation can delay the development of necrosis of the femoral head, andismost effective in smal lesion.

20 minutes and ≤ 60 minutes.Other 30 random ACI patients without TIA were included into Group B(Control Group).Several aspects were observed for comparing such as focus of infarction,neural function evaluation,pathological level and therapeutic effect.Re- sults ACI cases following T[A,Group AI patients' focuses of infarction were smaller and neural function evaluations were lower.There were also less serious patients.Group Al's Basic recovery rate,effective rate and total effective rate were higher than Control Group(P0.05).Con- clusion The proper lasting BIP(ATI) can provide neuroprotective effect to the ACI following.

Objective To report the functional reconstruction and rehabilitation for a patient who under- went allograft for both of his forearms and hands.Methods One male patient underwent allograft for both of his forearms and hands in October 2002 in our department to reconstruct his hand functions.The allografted hands were intervened with an integrated rehabilitation program,which involved administration of immunosuppressants,post- operative monitoring,postoperative functional training,massage,physiotherapy,orthosis,performance training, sensation training,secondary operation and mental rehabilitation.The patient was followed up for 4 years.Results The forearms and hands of the patient were in good shape and regained nearly normal sensation.The distance of two-point-discrimination was 2.5 cm to 4.0cm.The TAM (total active motion) of fingers was fine.The patient could look after himself well and were healthy in psychology.Conclusion An integrated rehabilitation program can yield satisfactory results in the management of allografted forearms and hands.