OBJECTIVE: To prepare diclofenac sodium hollow suppository and establish its quality control. METHODS: The hollow type suppository was prepared with mixed fatty glyceride as the base; the content of diclofenac sodium was deter-mined by ultraviolet spectrophotometry. RESULTS: The linear range of diclofenac sodium was 5～25 ?g?mL-1(r=0.999 7),with an average recovery rate of 102.04%(RSD=1.08%). CONCLUSION: The preparation technology of diclofenac sodium hollow suppository is simple and feasible,and the quality of the suppository is stable and controllable.

Objective To summary the color Doppler imaging feature of localized Castleman disease.Methods From January 1997 to November 2011,32 localized Castleman diseases which were proved by pathology were analyzed.Results Round-like,hypoechoic,hypervascular lesions were showed in 23 hyalinevascular type lesions,2 of them with calcium,3 of them with structure liked lymph node hilum.Round-like,hypoechoic,hypervascular lesions or normal lymph node were showed in 5 plasma- type lesions and 4 mixed type lesions.Conclusions When round like,hypoechoic,hypervascular lesion is found by ultrasonography,Castleman should be considered.Calcium or lymph nod hilum-like structure is special finding in diagnosis of Castleman disease by ultrasonography.

Objectives To detect gene mutation associated with hemophagocytic lymphohistiocytosis (HLH) and to identify mutation spectrum and clinical feature in HLH in children. Methods Thirty-seven (37) pediatric patients diagnosed with HLH according to 2004 clinical and laboratory criteria were enrolled from July 2012 to November 2015. Nucleotide sequences of all exons and their flanking intronic sequences of ten genes associated with HLH were amplified with PCR followed by direct sequencing. Point mutation analysis was performed after the direct sequencing. Results The median age of all the 37 patients was 2.6 years. The median ages of patients with gene mutation (n=22) and without gene mutation (n=15) was 2.09 years and 2.67 years, without statistical significance. Twenty-two patients were identified with gene mutations. All of them were heterozygous. UNC13D mutation (50%) is of the highest frequency in the above genes. The splicing mutations (38%) were the main type of UNC13D mutations,and missense mutations or frame-shift mutations were also found. There was no statistical difference in ages of onset and laboratory data of neutrophils, thrombocytes, NK cell activities within the three groups: multi-site mutations, single-site mutations and no mutations. EBV infection was detected in 70.3% patients. In mutation group, one patient died when he was in the period of inducing remission, and four patients were relapsed. Among them four patients were infected with EBV and one patients was negative at the onset while positive in recurrence. Conclusions UNC13D was the predominant causative gene in the Chinese population according our data. There was no significant relevance between age of onset, severity of disease and gene mutations. Attention should be paid to a patient with HLH gene mutation infected by EBV, which it might mean a poor prognosis.

With the roaring development of bioscience and its application in medicine, molecular diagnosis specially gene diagnosis shows striking advantages in disease diagnosis, treatment and prognostic assessment.Mo-lecular diagnosis mainly includes prenatal genes diagnosis the children of gene diagnosis and adult genetic diagno-sis.Molecular diagnosis is expounded from the aspects of medical practice in the field of medical ethics problem and how to correct the medical practice of molecular diagnosis of work, designed to guide all the medical workers to form the correct ethics in the field of molecular diagnostics.

Objective To apply E- learning in training of related knowledge about public health emergencies in emergency department in order to improve the treatment level of medical staff in public health emergencies. Methods The medical staff was divided into the observation group and the control group with 50 persons in each group according to the odd and even grouping method. The control group was given conventional training method, while the observation group received E- learning based on conventional training method. The theoretical test results and training effect were compared between two groups. Results The scores of the observation group were obviously higher than that of the control group [ (90.88 ± 4.09) points vs. (84.36± 4.92) points ], Z= -5.895, P<0.01. Conclusions The application of E- learning in the training of public health emergencies is beneficial to help the medical staff to obtain and share information resources more conveniently, to enhance the ability of the clinic medical workers of understanding the condition of emergent public health affairs, to elevate the grades of theoretical learning of the relevant knowledge and to improve the management level of training, training effect and efficiency.

Objective To analyze the clinical,muscle pathological features and molecular mutations in the 2 Chinese Han siblings with limb-girdle muscular dystrophy(LGMD) and conclude the phenotype/genotype correlations.Methods Clinical and muscle pathological data were collected.Genomic DNA of the two siblings and their parents were extracted using standard procedures from the peripheral leukocytes.A custom of targeted gene panel including 61 neuromuscular genes were designed by using the Agilent Sureselect Target Enrichment Kit.Targeted next generation sequencing(NGS) was performed in the proband,and CAPN3 gene mutation was verified with Sanger sequencing in the two siblings and their parents.The dbSNP138 and http://www.dmd.nl were searched to determine the disease-causing mutations.Results The proband slowly showed muscle weakness profoundly with pelvic muscles,developed difficulty in squatting and standing and climbing stairs.She had a tight Achilles tendon,high CK level (1 908-9 241 IU/L),without winging scapula and hypertrophy calf.The affected brother was only diagnosed hyper CKemia.By using the targeted NGS,the two siblings possessed the same two compound heterozygous mutations(c.717delT and c.2243G ＞ A) in CAPN3 gene.The two mutations both were verified by Sanger sequencing and had been reported before.Conclusions LGMD is clinically and genetically heterogeneous,and targeted NGS is powerful in defining the causal mutation of LGMD and helpful in investigating the exact genotype/phenotype analysis.

Objective To observe the clinical efficacy of point injection at Xialiao point (BL 34) for levator ani syndrome. Methods A hundred levator ani syndrome patients were randomly allocated to a treatment group and a control group, 50 cases each. The treatment group received point injection at Xialiao point (BL 34) and the control group was intervened by biofeedback therapy. The Visual Analogue Scale (VAS), component scores of the MOS 36-item Short-From Health Survey (SF-36), anal resting and squeeze pressures were recorded in the two groups before and after the treatment. The therapeutic effects and therapy costs were compared between the two groups.Results The VAS, component scores of SF-36, anal resting and squeeze pressures were significantly changed after intervention in the two groups (P<0.05). After treatment, the VAS, a part of the SF-36 score [physiological function (PF), body pain (BP), vitality (VT) and social function (SF) scores], anal resting and squeeze pressures in the treatment group were significantly different from that in the control group (P<0.05). The total efficacy rate was 88.0% in the treatment group versus 80.0% in the control group, and the difference was statistically significant (P<0.05). The therapy costs in the treatment group were (327.31±13.42) RMB and (408.45±21.56) RMB in the control group, and the difference was statistically significant (P<0.01).Conclusions Point injection at Xialiao point (BL 34) is an effective method for levator ani syndrome.

Objective To observe the clinical efficacy of wrist-ankle acupuncture in treating pain due to laparoscopic cholecystectomy.Method Totally 150 patients who were going to receive laparoscopic cholecystectomy were randomized into group A, group B, and group C, 50 cases in each group. Group A was intervened by wrist-ankle acupuncture prior to anesthesia, with the needles retained for 12 h; group B was by subcutaneous needling at the area nearby the points prior to anesthesia, with the needles retained for 12 h; group C didn’t receive any intervention before anesthesia. For the three groups, general inhalational and intravenous anesthesia was adopted for surgery, and patient-controlled intravenous analgesia for post-operation analgesia. The incision pain and visceral pain in the three groups were recorded by using Visual Analogue Scale (VAS) respectively 1 h, 2 h, 4 h, 8 h, 12 h, 24 h, 36 h, and 48 h after the operation. The total effective rate, analgesics consumption after operation, and incidence rate of adverse reaction were compared.Result There were significant differences in comparing the VAS scores of incision pain and visceral pain between group A and group C 4 h, 8 h, 12 h, 24 h, and 36 h after the operation (P<0.01,P<0.05). Between group A and group B, there were significant differences in comparing the VAS score of incision pain 8 h, 12 h, 24 h, and 36 h after the operation and the VAS score of visceral pain 12 h, 24 h, and 36 h after the operation (P<0.05). The total effective rate was 96.0% in group A, which was significantly different from 84.0% in group B and 86.0% in group C (P<0.05). The consumption of Fentaneyl citrate injection was (52.4±10.8)μg in group A, which was significantly different from (92.2±11.0)μg in group B and (107.2±11.5)μg in group C (P<0.05,P<0.01). The incidence rate of adverse reactions was 12.0% in group A, which was significantly different from 58.0% in group B and 66.0% in group C (P<0.01).Conclusion Wrist-ankle acupuncture plus patient-controlled intravenous analgesia can mitigate pain after laparoscopic cholecystectomy, and thus it can be taken as one of the post-operational analgesic approaches.

Forty girls with Turner's syndrome (TS),aged (12.6 ± 1.9) years,were treated with daily subcutaneous injection of recombinant human growth hormone (rhGH,1.0 ～ 1.1 IU · kg-1 · w-1) and oral stanozolol (0.02 ～ 0.04 mg · kg-1 · d-1) for 1 ～ 5 years.Growth velocity (GV),height standard deviation score (SDS) by reference of healthy Chinese girls (HtSDSNor) and height SDS by reference of untreated Chinese TS girls (HtSDSTs)were evaluated regularly.Of the forty girls studied,thirteen had discontinued the treatment after a mean duration of (2.9 ± 1.2)years when GV was less than 2 cm/year or when patients were satisfied with the achieved height.Final adult height (FAH) or near-final height,which was defined as the most recent available height after discontinuation of treatment,and the height gained in the thirteen girls were evaluated.Estrogen therapy was started at the age of(16.0 ± 1.1) years.HtSDSNor increased from-4.2 ± 1.0 to-3.4 ± 1.0 in the first year,and-2.8 ± 1.0,-2.4 ± 0.8,-2.5 ± 0.5,-2.3 ±0.3 respectively in the 2nd,3rd,4th,and 5th year.The change in HtSDSTs was similar to HtSDSNor.It was increased from 0.1 ± 0.9 to 1.0 ± 0.9 in the first year,and to 1.5 ± 0.8,1.9 ± 0.6,1.7 ± 0.4,1.7 ± 0.2 in the subsequent 4 years.The predicted adult height (PAH) in 13 girls was (142.8 ± 4.2) cm before treatment.FAH was (151.7 ± 4.1) cm,which was significantly higher than PAH (P＜0.01),and the mean height gain was (8.9 ± 2.8) cm (5.1 ～ 12 cm).FAHSDSNor was increased to-1.6 ± 0.8 from-3.8 ± 0.8.For girls with TS around 9 years of age,combined therapy with rhGH and low dosage of stanazolol may significantly increase growth velocity and improve final adult height.

Objective To investigate the effects of propofol on intracellular free Ca2+ concentration and nitric oxide synthase (NOS) activity in PC12 cells exposed to bupivacaine. Methods The PC12 cells were provided by Shanghai Cell Biology Research Institute, Chinese Academy of Sciences and cultured in DMEM liquid culture medium. The cultured PC12 cells were seeded in 36 well plates and randomly assigned to one of 4 groups (n=9 wells each): group Ⅰ control (C);group Ⅱ propofol (P);group Ⅲ bupivacaine (B) and group Ⅳ propofol + bupivacaine (PB). In control group D-Hank solution was added. The cells were exposed to propofol 2 mmol/L and bupivacaine 0.09 mmol/L in group P and B respectively. In group PB the cells were incubated with propofol 2 mmol/L and bupivacaine 0.09 mmol/L simultaneously. After being incubated for 6 and 24 h the apoptosis in BC12 cells was assessed by flow cytometry. Apoptotic rate was calculated. NOS activity and intracellular free Ca2+ coneentration in PC12 cells were determined. Results Bupivacaine significantly increased the apoptotic rate of PC12 cells, the intracellular free Ca2+ concentration and NOS activity in PC12 cells in group B as compared with control group. Propofol significantly decreased the toxic effects of bupivacaine on PC12 cells in group PB compared with group B. Conclusion Bupivacaine is toxic to PC12 cells by increasing apoptosis, intracellular Ca+ concentration and NOS activity in the cells. The toxic effects can be prevented to some extent by concomitant administration of propofol.