Four adults of Fasciola hepatica were found from the bile ducts of a patient diagnosed as biliary calculi during a surgi-cal operation. We investigated retrospectively the infection source and concluded that the patient may be infected by eating raw or half-cooked Zizania latifolia,an aquatic plant,which was contaminated with metacercariae of F. hepatica.

Objective:To prepare the thermosensitive nasal gel of ephedrine hydrochloride and diphenhydramine hydrochloride and establish its quality control method. Methods:The amounts of P407, P188 and PEG 6000 were optimized by an orthogonal test with the gelling temperature as the index. An HPLC method was established to determine the contents of ephedrine hydrochloride and di-phenhydramine hydrochloride. Results:The optimum amount of P407, P188 and PEG 6 000 was 19%, 2% and 1%, respectively. The linear range of ephedrine hydrochloride was 1.600 0-2.400 0 mg·ml-1(r=0.999 6), and the average recovery was 99.76%with RSD of 1. 02%(n=9). The linear range of diphenhydramine hydrochloride was 0. 160 0-0. 240 0 mg·ml-1(r=0. 999 7), and the average recovery was 101. 27% with RSD of 1. 10%(n=9). Conclusion:The formula design and preparation technology of the gel are feasible. The HPLC method is suitable for the quality control of the preparation.

OBJECTIVE:To investigate the utilization of opioid analgesic drugs in a hospital,so as to provide reference for ra-tional drug use in clinic. METHODS:The utilization of opioid analgesic drugs in the hospital during 2014-2016 was analyzed and compared retrospectively in terms of consumption sum,DDDs,DDC,B/A,etc. RESULTS:Annual consumption sum of opioid an-algesic drugs in the hospital increased slightly in 2015,but decreased significantly in 2016. Fentany transdermal patches(8.4 mg), Oxycodone and acetaminophen tablets and Remifentanil hydrochloride for injection always took up the first 3 places in the list of DDDs. DDDs of Fentanyl citrate injection(0.1 mg)and Morphine sulfate sustained-release tablets increased year by year;while DDDs of Fentany transdermal patches(4.2 mg)and Fentany transdermal patches(8.4 mg)decreased year by year. DDC of all opi-oid analgesic drugs decreased in 2016,with the cancel of drug price addition at the end of 2016. B/A values of most drugs were close to 1.0;while B/A value of Oxycodone hydrochloride sustained-release tablets(40 mg)was much less than 1.0,and that of Fentany transdermal patches(8.4 mg)and Oxycodone and acetaminophen tablets were significantly more than 1.0 for consecutive 3 years. CONCLUSIONS: The variety and specifications of opioid analgesic drugs in the hospital is comprehensive during 2014-2016. The clinical utilization of opioid analgesic drugs is generally rational,but still needs to be supervised effectively and par-ticularly,so as to improve standard use of opioid andalgesic drugs.

Objective In embryology, the pancreas is formed by fusion of the ventral pancreas(VP) and the dorsal pancreas(DP) during the seventh week of gestation. The aim of this study was to clarify whether there were differences in the clinicopathological characteristics of the carcinoma of pancreatic head(PhCa) arising from the VP and DP. MethodsResected specimens from 43 cases with PhCa were studied histologically and immunohistochemically. The VP and DP were distinguished by islet shape and amount of cells producing pancreatic polypeptide(PP) in normal pancreatic parenchyma adjacent to the main tumor. ResultsThere were 20 cases of PhCa from VP(VP-group) and 23 cases of DP (DP-group) in this study. The prognosis of the 20 patients in VP-group was significantly better than that of the 23 in DP-group ( P

The historical surveillance results showed, there were 10 schistosomiasis cases in Huangshan City from 1994 to 2006. The survey in 2007 showed, the positive rates of blood examination for schistosomiasis in migrant workers and immigrant workers were 0.49% and 0.47% , respectively, but no schistosome-infected patients were detected by using the stool examination. An area with snails of 3 000 m~2 was found in the residence of the immigrant workers, but no infected snails were found. It is indicated that the mobile population has some impact on the transmission of schistosomiasis in the transmission-interrupted area. The surveillance and health education for the mobile population should be strengthened, and the imported infectious source should be prevented.

Objective To explore the relationship between left ventricular diastolic function and the dynamic changes of myocardial ultrastructure and argyrophilic fiber in diabetic rats on the different periods of lesions(week 4,12 and 24).Methods The diabetes mellitus(DM)in healthy male Sprague-Dawley rats was induced by a single injection of streptozotocin(STZ,Sigma)into intraperitoneal at a dose of 65 mg/kg body weight.The left ventricular diastolic function was measured by Color Doppler Flow Imaging-Pulsed Wave(CDFIPW)and Doppler Tissue Imaging(DTI)echocardiography.Heart tissue at the apex was obtained rapidly for transmission electron microscope study.Argyrophilic staining was used in the study of argyrophilic fiber volume fraction(APFVF)in heart interstitial tissue.Results Diastolic dysfunction of left ventricle was detected in STZinduced diabetic rats by CDFI-PW(E/A ＜ 1)at week 4,and progressed gradually.Pseudonormal filling (E/A ＞ 1)was found in diabetic rats at week 24,which could be identified by DTI(Ea/Aa ＜ 1).Diastolic function of normal rats was not impaired(E/A ＞ 1 and Ea/Aa ＞ 1).Transmission electron microscopy revealed a spectrum of subcellular remodeling in myocardium which was characterized by myofibril content decrease,disorganization,mitochondrial degeneration,sarcoplasmic reticulum,structural disorder.Compared with the control group,APFVF in myocardium was increased significantly in diabetic rats(P ＜ 0.05).Conclusion The diastolic dysfunction in STZ-induced diabetic rats correlates with damage of ultrastructure and increase of myocardial argyrophilic fiber.

Objective To analyze the changes of serum C-type lectin domain family 11 member A(Clec11a)in the progression of diabetic kidney disease(DKD)and evaluate its value in bone metabolism.Methods The clini-cal data of 184 patients with type 2 diabetes(T2DM)were collected and serum Clec11a levels were detected.Ac-cording to the UACR,patients were divided into non-albuminuria group of 76 cases,microalbuminuria group of 72 cases and macroalbuminuria group of 36 cases.In the same period,50 healthy subjects were selected as control group.The general clinic data,bone mineral density and bone metabolism indexes of all groups were measured.The correlation between Clec11a level and bone metabolism indexes of DKD patients was analyzed.Results Levels of Clec11a and eGFR in all T2DM subgroups were significantly lower than those in normal control group(P＜0.05).Levels of Clec11a and eGFR in T2DM subgroups significantly decreased with the increasement of UACR(P＜0.05).Bone mineral density(BMD)of neck of femur and Clec11a levels in microalbuminuria group were lower than those in non-albuminuria group(P＜0.05).The levels of Clec11a and BMD of lumbar vertebra in macroalbu-minuria group were lower than those in microalbuminuria group(P＜0.05).Bone metabolism indexes such as 25 hydroxyvitamin D[25(OH)D],N-terminal fragment of osteocalcin,amino terminal peptide of type Ⅰ procollagen,parathyroid hormone,and β collagen degradation products were not significantly different between microalbuminuria group and non-albuminuria group.BMD,25(OH)D and Clec11a levels were negatively correlated with UACR levels(P＜0.05).Clec11a had the strongest correlation with UACR.Conclusion Serum Clec11a levels in T2DM pa-tients significantly decreased with the increasement of UACR.Compared with other bone metabolism indexes,Clec11a showed a stronger negative correlation with UACR.Regular detection of serum Clec11a levels for DKD pa-tients is conducive to identify bone loss early.

Objective:To analyze and summarize the clinical and genetic features of Noonan syndrome (NS) caused by mutations in the leucine zipper-like transcription regulator 1 ( LZTR1) gene. Methods:The retrospective study analyzed a patient who was examined at the Center of Prenatal and Hereditary Disease Diagnosis, Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University in January 2021 because of fetal nuchal translucency thickening and a previous history of problematic pregnancies. Subsequently, the patient was diagnosed with Noonan syndrome (NS) through whole exome sequencing. Using keywords such as "Noonan syndrome," "Leucine zipper-like transcription regulator 1", and " LZTR1", clinical and genetic characteristics of NS derived from LZTR1 mutations were summarized by extracting relevant literature from China National Knowledge Infrastructure, Wanfang Database, Yiigle, PubMed and Web of Science, covering from January 2013 to October 2022. Descriptive analysis was applied to the data. Results:(1) Case report: WES and Sanger sequencing showed the existence of the biallelic variants of LZTR1 gene c.842C>T and c.2248G>A in the fetus (Ⅱ-3) and the proband (Ⅱ-2) that inherited from the father and the mother, respectively. Based on the typical special facial appearance and short stature in the proband indicative of NS, the fetus and the proband were diagnosed with autosomal recessive inheritance (AR) NS. The pregnant woman terminated her pregnancy at 22 weeks due to severe edema of the fetus. At the age of three, the proband exhibited typical craniofacial features and short stature characteristics of NS when presented to our hospital. The proband received regular follow-ups in the pediatrics department of other hospitals, where recombinant human growth hormone was used to improve his height. He attended kindergarten at age four and can communicate and play with other children normally. (2) Literature review: 95 cases of NS associated with LZTR1 mutations have been retrieved and included. When including the fetus and the proband of this case, the total reached 97 cases, involving 79 different mutation sites. Forty-three cases (44.3%) were AR, and 54 (55.7%) were autosomal dominant inheritance (AD). Missense mutation was the most prevalent type of mutation, whereas nonsense mutation and frameshift mutation were more common in biallelic variants. Across all cases, the clinical manifestations encompassed multiple systems, primarily characterized by craniofacial dysmorphia, skeletal deformities, heart defects, and short stature. Developmental delay, learning disabilities, and mental retardation of varying degrees may accompany these symptoms. Eighteen cases described antenatal phenotypes, with 16 of them reporting biallelic AR variants. Ultrasound findings of 18 prenatal cases revealed 11 cases of fetal NT thickening, seven cases of cystic hygroma, four cases of fetal pericardium or pleural effusion, two cases of severe fetal edema, and 11 cases of cardiovascular defects. Conclusions:NS induced by LZTR1 mutations is an autosomal dominant or recessive inherited genetic syndrome with a broad spectrum of clinical phenotypes. The severity of the disease varies among children with the same genotype. NS should be considered when prenatal ultrasound indicates nonspecific manifestations, such as fetal NT thickening, cervical lymphatic hydrops, polyhydramnios, fetal edema, and congenital heart defects. Prenatal identification is crucial for evaluating the prognosis of children and assisting families in making clinical decisions.

As the window of the hospital,the emergency department's medical quality determines the medical quality of the entire hospital.Emergency medical safety is the key to hospital construction.However,due to problems such as staffing and medical technology in the department of emergency of Chinese Medicine Hospitals,the development of medical quality is highly unbalanced.Aiming at the medical safety problems in the department of emergency of Chinese Medicine Hospitals in our country,the department of emergency of the Second Affiliated Hospital of Guangzhou University of Chinese Medicine analyzed the current situation at home and abroad,examined the causes of medical errors,and put forward suggestions for the reform of medical safety in the department of emergency of Chinese Medicine Hospitals.It is recommended to effectively reduce medical errors through a series of reform measures such as hardware transformation and upgrading,standardization of standard procedures,establishing a sound communication mechanism,and creating a safety culture.