Objective: To study the preparation method and process optimization of methylphenidate hydrochloride biphasic controlled-release osmotic pump tablets.Methods: Based on the preparation technology of double-layer osmotic pump slow-release tablets and combined with the principle of biphasic drug release behavior, the two-release preparation with two different release phases was prepared.Through the single-factor investigation of the drug-containing layer and the booster layer, the amount of the auxiliary materials was determined.The optimum compression method and the optimum coating parameters were obtained by studying the process parameters of tabletting and coating.Results: The prepared methylphenidate biphasic controlled-release osmotic pump tablets had two different release phases.The methylphenidate hydrochloride controlled-release osmotic pump tablets produced by the optimal formulat were good in appearance and reproducibility of drug content.In vitro release curves showed that the drug was released rapidly in the intial 0-2 hour time interval and was in line with zero-order release in 2-10 hour with good reproducibility.Conclusion: The preparation method is scientific, simple and complete, and can be used for preparation of methylphenidate hydrochloride biphasic controlled-release osmotic pump tablets.

Protein disulfide isomerase A3 (PDIA3) is a member of protein disulphide isomerase family and widely exists in endoplasmic reticulum, cell surface, nucleus and mitochondria.PDIA3 promotes the glycoprotein folding and quality control in the endoplasmic reticulum and is also a key molecular of major histocompatibility complex class I mol-ecules assembly.In addition, PDIA3 is involved in the cell signal transduction and plays an important role in a variety of disease development.Therefore, this paper talks about the function of PDIA3, the relationship between disease and PDIA3 as well as its clinical outlook.

Objective:To study the effect of priming technique combined with time limit on shortening the onset time of cisatra-curium besilate. Methods:Totally 112 adult patients undergoing selective operation with general anesthesia were randomly divided into group A, B and C. Fentanyl with the dose of 4 μg·kg-1 and propofol with the dose of 2 mg·kg-1 were used in the three groups as the inducing agents. Group A was first with intravenous injection of cisatracurium besilate 20 μg·kg-1 , and 3 minutes later, the in-ducing agents and cisatracurium besilate with the dose of 80 μg·kg-1 were respectively injected. Group B was first with intravenous injection of cisatracurium besilate with the dose of l00 μg·kg-1 , and 1. 5 minutes later, the inducing agents were injected. Group C was respectively injected with the inducing drugs and cisatracurium besilate with the dose of l00 μg·kg-1 . The T1 percentage before the induction, the time of 90% and 100% inhibition of muscle twitching, the rating of trachea cannula and adverse drug reactions in the three groups were observed and compared. Results:There was no significant difference in the excellent rate of trachea cannula a-mong the three groups (P>0. 05). Compared with group A and B, group C showed no T1 suppression before the induction, while group B with T1 of (9. 8 ± 2. 6) was higher than group A with T1 of (3. 2 ± 1. 5) (P<0. 01). The time of 90% and 100% inhibition of muscle twitching in group C was the longest (P<0. 01), and the incidence of adverse drug reactions in group C was also the highest (P<0. 05). Conclusion:The application of priming principle and time limit can effectively shorten the onset time of cisatracurium be-silate with significant effect and high safety.

Objective:To observe the influence of sevoflurane and propofol anesthesia on hemodynamics in laparoscopic cholecys-tectomy. Methods:Totally 98 patients with laparoscopic cholecystectomy were randomly divided into P group and S group. P group was with propofol for anesthesia, and S group was with sevoflurane for anesthesia. Before anesthesia, 2min after intubation, 10 min af-ter intubation, 5min and 30min after pneumoperitoneum, and after the surgery, the levels of blood glucose and cortisol, and hemody-namic changes in the two groups were observed, and the incidence of adverse reactions was also studied. Results:2 min and 10 min af-ter the anesthesia, the blood glucose levels in the two groups were significantly lower than those before the anesthesia(P<0.05 or 0. 01), while 30 min after pneumoperitoneum and after the operation, the blood glucose levels were increased(P<0. 01). The blood glucose levels in S group after the operation were much lower than those in P group (P<0. 01). 2 min after intubation, cortisol was decreased in the two groups (P<0. 05 or 0. 01). 5 min after pneumoperitoneum and after the operation, cortisol levels were higher than those before the anesthesia in P group(P<0. 01), and 5 min and 30 min after pneumoperitoneum and after the operation, cortisol levels in S group were lower than those in P group (P<0. 01). HR and SPO2 showed no significant changes in the two groups during the whole process (P>0. 05). 2 min and 10 min after intubation, SBP in the two groups was decreased (P<0. 01), and 5 min and 30 min after pneumoperitoneum, there was notable difference in SBP between the groups (P<0. 01). 2 min and 10 min after intuba-tion, DBP was decreased in the two groups (P<0. 01), and the difference was significant between the groups (P<0. 01). 5 min and 30 min after pneumoperitoneum, DBP in P group had notable difference with that in S group (P<0. 05). The incidence of adverse re-actions in the two groups showed no significant difference (P>0. 05). Conclusion: Sevoflurane anesthesia in laparoscopic cholecys-tectomy can keep stable hemodynamics in the patients, and the anesthetic effect is better than propofol.

Based on the development and application of medical ultrasonic diagnosis information system(USIS) of Nanjing Maternity and Child Health Hospital,this article deeply expounds the requirement analysis and the database design of USIS's development.With the analyses of the distinguishing feature of ultrasonic diagnosis work flow and the design of the relational data structure of USIS,the thought and method to overcome the difficulty of data storage are proposed.

Improvements in severe burn and trauma care have enabled patients to survive massive bums and severe injury that would have once been fatal.Now up to 40％-70％ of patients develop hypertrophic scars after bums and trauma.The functional and psychosocial sequelae remain a major rehabilitative challenge,decreasing quality of life and delaying reintegration into society.So far,including surgical treatment,existing scar treatments have different degrees of limitations.In recent years,flap surgery and wound repair technology develop rapidly,such as perforator flap,flap dilation techniques,autologous scar composite skin,negative pressure wound treatment technology,the new technology of 3D and 4D bioprinting technology etc.These new technologies provide high quality tissue repair materials for clinical treatment of scar repair have a broad prospect of clinical application,and have achieved more satisfactory clinical repair treatment effect.The future need is to further strengthen the practice and innovation of scar repair,and the basic research and clinical application of scar should be strengthened and combined closely.The new elucidation of the scar prevention and therapeutic strategies should be put foward to improve the prognosis of patients with scar and the quality of life.

Objective To analysisthe evaluation clinical effects and complications of retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap for the re-pair of the leg and foot skin defect effect. Methods In January 2010 to January 2015,patients with leg and foot skin defect effect in our hospital administrated withperoneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle skin flap were retrospectively analyzed.Flap survival,necrosis rate, the function of the skin flap and complications were analyzed. Results The one stage flap survival rate of peroneal artery group(84.6%)is higher than the posterior tibial artery group(57.69%),the difference was statistically sig-nificant(P < 0.05). There were no significant difference between the flap function index(pain,activity limita-tion,wearing shoes,functional recovery satisfaction)score and posterior tibial artery group(P>0.05). The occur-rence of hyperplastic scar,itching,pigmentation,skin graft,numbness,skin graft abnormal pain complication rates inperoneal artery group were significantly lower than the posterior tibial artery ,and the difference was statisti-cally significance(P < 0.05). Conclusion Retrograde peroneal artery perforators and retrograde posterior tibial artery fascia pedicle flap perforators fascia pedicle flap can effectively repair skin and soft tissue defect ,retrograde peroneal artery perforators shows with higher survival rate and less complication.

Objective:To explore the effects of brain ischemia on the immune system and the expression of Acetyl-cholinesterase(AChE) and Caspase-3 after neuro-immunological injury.Methods:The serum IL-4,IL-10,TNF-?,IL-2 and IL-12 concentrations and AChE level in brain,thymus and spleen of the rat brain ischemia at different time spots were detected by ELISA.The active fragments of Caspase-3 P17 and P32 in brain,thymus and spleen were tested by Western blot.The expression of AChE in nerve cells was examined immunohistochemistry.The relationship between amount of AChE and concentrations of the cytokines or NK activity as well as cell apoptosis was analyzed.Results:The concentration of AChE in brain increased gradually after ischemia,the level reached peak after 12 hours,and then decreased afterward.The AChE level in thymus and spleen increased after 1 h in accordance with the ischemic brain.The NK activity,serum TNF-?,IL-2 and IL-12 levels also increased at 0.5 h,1 h and 2 h after ischemia,but the trend reversed after 3 hours.Serum IL-4 and IL-10 levels did not change significantly at 0.5 h,1 h and 2 h after ischemia,but serum IL-10 raised after 3 hours to 48 hours.Serum IL-4 level slightly increased only appearing at ischemia 12 h point.The ratio of P17/(P17+P32) became higher with ischemic time.Conclusion:Sustained rising of AChE level due to brain ischemia induces the apoptosis of cells in the brain,thymus and spleen via activation caspase-3,leading to Th1/Th2 imbalance and immune dysfunctions.