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To establish a LC-MS/MS method which is accurate and sensitive for determination of koumine, gelsemine, and gelsenicine in biological samples and to verify the method.Strychnine was used as internal standard. Analytes in blood, urine and liver with 1% sodium hydroxide solution were extracted by ethyl acetate. Chromatographic separation was achieved on a ZORBAX SB-C₁₈ column （150 mm×2.1 mm, 5 μm）, and gradient elution was performed with the buffer solution of methanol-20 mmol/L ammonium acetate （including 0.1% formic acid and 5% acetonitrile） as mobile phase. Qualitative and quantitative analysis was performed in the multiple reaction monitoring mode coupled with an electrospray ionization source under positive ion mode（ESI⁺）.The linearity of koumine, gelsemine and gelsenicine in blood, urine and liver was good within corresponding linear limitation and the correlation coefficients （The method is selective, sensitive and suitable for simultaneous determination of koumine, gelsemine and gelsenicine in body fluids and tissues, which offering technical support for clinical diagnosis and treatment and forensic toxicological analysis of

To investigate the clinical efficacy of minimally invasive 23G vitrectomy combined with chandelier for the treatment of superior bullous rhegmatogenous retinal detachment (SBRRD).A retrospective case series study of 50 patients with SBRRD was conducted. Each of these patients received minimally invasive 23G vitrectomy in one of their eye. A trocar was indwelled with two-step 23-G incision, and the chandelier was inserted in the inferior 6 o'clock pars plana. The tear was closed with 23-G vitrectomy combined with endolaser photocoagulation and infused with perfluoropropane (C3F8) under non-contact wide-angle lens. Postoperative follow-up ranged from 5-49 months (mean 23.9±1.3 months). Intraoperative and postoperative complications, postoperative conjunctival hyperemia, eye irritation signs and inflammation reactions, retinal anatomic reduction rate, best corrected visual acuity (BCVA) and intraocular pressure (IOP) changes were analyzed.The intraoperative scleral incision leakage required 17 sutures (34%). No complications, such as iatrogenic retinal breaks and hemorrhage occurred. The postoperative conjunctival hyperemia, eye irritation signs and inflammation reactions were mild. Transient low IOP occurred in one eye (2%) on the first day postoperatively and recovered on the next day. Transient low IOP occurred in eyes of 16 subjects (32%) and recovered after lowering IOP therapy within an average of 4 days. No complications, such as hemorrhage, effusion, choroidal detachment and endophthalmitis were observed. Forty-nine subjects (98%) had retinal reattachment in their eyes after a single surgery, and 100% eyes showed final retinal reattachment. The preoperative and postoperative BCVAs were 4.61±0.19 and 4.70±0.19, respectively, in 8 patients without detached macula, and the difference was not statistically significant (t = 2.20, p0.05).Minimally invasive 23G vitrectomy combined with chandelier is a safe and effective surgical approach for the treatment of SBRRD.

To determine the curative effect and complications of 23G vitrectomy via corneal approach for the treatment of pediatric cataract.We performed anterior circular capsulotomy, lentectomy and aspiration, posterior circular capsulotomy, and anterior vitrectomy via corneal approach in 40 eyes from 25 children with congenital cataract. In patients aged2 years, foldable intraocular lens (IOL) was implanted and frame glasses were prescribed at younger age. The intraoperative/postoperative complications, comfort level, and inflammatory reaction after surgery were observed.No intraoperative complications occurred and 9 eyes were simultaneously implanted IOL. All patients could blink normally except one child who suffered from corneal epithelial abrasion for one day. All corneas were clear and only mild postoperative inflammation was observed. There was no hyphema, effusion, hypotony, and hypertension. A week later, the mild congestion also disappeared. All parents reported good vision of their babies allowing them free play during 3-50 months follow-up. This surgical technique provided a clear 4-6 mm diameter visual axis and circular pupil in all cases. The IOL positions were centered at the pupil area. No secondary cataract developed.The 23-gauge vitrectomy via corneal approach for the treatment of pediatric cataract involves only mild discomfort and fewer complications.

A total of 54 cases (73 hips) with ischemic necrosis of the femoral head after treatment of CDH have been followed up with an average of 7 years. We found that 89% cases of type I and 70% of type II recovered to normal and 83% cases of type III and IV developed the coxa breva deformity due to injury of longitudinal growth plate of the proximal end of the femur. According to the value of ATD, the coxa breva was divided into three types. The L shape growth disturbance line revealed by X-ray is considered as a marker for determination of early epiphyseal plate injury by the authors.

Thirty-four hips were observed radiographically to see the development of the femoral head. The intramedullary pressure was measured in the proximal femur before and after treatment of congenital dislocation of the hips. The intramedullary pressure in the avascular femoral head decreased more obviously than that in the normal head after treatment. A term of "IMP subtraction value" was put forward as an objective index for evaluating the development of the femoral head after treatment of congenital dislocation of the hip.

Intramedullary pressure in the proximal femur was measured before and after treatment of congenital dislocation of the hip. The intramedullary pressure before treatment was higher than that of the control group, and after treatment it was lower as a whole; in the close reduction group the pressure decreased as compared with the operation group. In 8 hips, stress test yielded negative results. These findings suggested the characteristics of arterial blockage may be that the potential cause of avascular necrosis of the femoral head after treatment of congenital dislocation of the hip.