In 1988, Zhibiao Wang had an inspiration of ablating tumor in vivo non-invasively by high intensity focused ultrasound (HIFU). In the following 10 years, he and his team first proposed concepts such as "biological focal region", "ultrasound therapy dosimetry", "acoustic environment in tissue" and so on. They had broken down the key technical barriers in real-time ultrasound monitoring, treatment system optimization, telemedicine system, clinical protocols and other aspects, making HIFU therapy successfully applied to surgery and accumulated the largest number of clinical cases internationally. They have been playing a leading role around the world in equipment development, clinical application and some basic research in this field.

Glycogen synthase kinase-3β (GSK-3β) is a serine/threonine protein kinase, which takes part not only in glycogen metabolism, but also in cell proliferation, differentiation and apoptosis. GSK-3β is inhibited by growth factors and hypertrophic stimuli through phosphorylation of its N-terminal end serine (Ser9) residue. It is also activated by phosphorylation of its tyrosine (Tyr216) residue. GSK-3β is profoundly inactivated in mice with hypertrophic cardiomyopathy (HCM) and plays a secondary role in myosin heavy chain mutation. However, the role of GSK-3β in HCM was controversial. Recent studies have demonstrated that the activation of GSK-3β inhibits the myocardial hypertrophy, and is regulated by Wnt/Frizzld and PI3-K/Akt signaling pathways. This article introduces the molecular role of glycogen synthase kinase-3β signaling in myocardial hypertrophy and the different pathways on the activity of glycogen synthase kinase-3β (GSK-3β)

Glycogen synthase kinase-3? (GSK-3?) is a serine/threonine protein kinase,which takes part not only in glycogen metabolism,but also in cell proliferation,differentiation and apoptosis. GSK-3? is inhibited by growth factors and hypertrophic stimuli through phosphorylation of its N-terminal end serine (Ser9) residue. It is also activated by phosphorylation of its tyrosine (Tyr216) residue. GSK-3? is profoundly inactivated in mice with hypertrophic cardiomyopathy (HCM) and plays a secondary role in myosin heavy chain mutation. However,the role of GSK-3? in HCM was controversial. Recent studies have demonstrated that the activation of GSK-3? inhibits the myocardial hypertrophy,and is regulated by Wnt/Frizzld and PI3-K/Akt signaling pathways. This article introduces the molecular role of glycogen synthase kinase-3? signaling in myocardial hypertrophy and the different pathways on the activity of glycogen synthase kinase-3? (GSK-3?)

Objective To inquire into the hurt-efforts to the rabbit femoral in vivo irradiated by high intensity focused ultrasound(HIFU). Methods Using a HIFU with the operating frequency of 0.8 MHz; the focal distance of 135 mm and the sound-intensity of 8000 W/cm 2. The average interal diameter of the rabbit femoral artery was about 1.1 mm.Thirty rabbits were divided into 3 groups randomly and unilateral-femoral was chosen at random. To observe by using the method of pathology and victorian blue of elastic fibre. Results After irradiation all the endothetial cells of blood vessels of the rabbit peeled off,disappeared and tiny thrombuses were formed in the vessels the core of smooth muscles withered, cell disorder appeared. Conclusions Irradiation by HIFU could cause injury to the rabbit femoral artery, change blood dynamics and produced contribution to the further research on the energy accumulation of the targets in HIFU system.

Objective To explore the efficiency,safety and suitable dosage of the non-invasive treatment of malignant gliomas with high intensity focused ultrasound(HIFU).Methods An extracorporeal HIFU with 9.7 MHz transducer(focal length: 4.5 mm,focal intensity: 2 500 W/cm~(2)) was used.Fifteen resected human malignant gliomas were randomly assigned to receive HIFU ablation for 10,20,30 s.After the treatment,the exposure coverage and marginal zone were collected and examined by HE staining and electron microscope.Results Exposure coverage and margin was safe in 10 s group.Typical coagulation necrosis was detected at exposure coverage with no detectable change at margin in 20 s group.Typical coagulation necrosis was seen at both exposure coverage and margin in 30 s group.Conclusion Under the parameters used in this study,20 s is a beneficial therapeutic dosage.HIFU is an accurate method for malignant gliomas ablation.

Objective To investigate the enhancing effect of microbubble contrast agent SonoVue of different dosage on high-intensity focused ultrasound (HIFU) ablation in goat livers in vivo. Methods Twenty goats were divided into 4 groups randomly. Animals in group 1,2 and 3 were bolus-injected of 0.01 ml/kg,0. 03 ml/kg and 0.05 ml/kg of SonoVue intravenously before HIFU exposure, respectively,and those in group 4 were not given injections as control. After injection 20s, the livers were ablated using HIFU performed in the manner of a single dot set by a computer system using a clinical device. The frequency of HIFU was 0.8 MHz,the intensity of HIFU was 19 100 W/cm2 ,the distance from skin to the target liver tissue was 30 mm,the exposure time was set at 15 s for all animals in the four groups. All animals were euthanized 7 days after HIFU, volumes of coagulated necrosis were measured. Pathological examinations were performed to analysis the exposure regions. Results Under the same parameters of exposure, coagulated volumes in group 1,2 and 3 were larger than those in group 4, the difference was significant (P < 0.05),and the coagulated volumes increased gradually with the dosage of SonoVue increasing from group 1 to group 3, the difference was significant (P<0.05). Pathological examinations confirmed that there were no residual unaffected tissues within the exposed volume. Two remarkable changes were observed in one goat in group 37 days after HIFU:the surrounding adjacent tissue outside the reactive zone necrotized and the skin were destroyed. Conclusions The enhancing effects of microbubble contrast agent in HIFU ablation is related with the dosage of the microbubble contrast agent SonoVue. The higher the SonoVue dosage,the larger the volume destroy in the target tissue.

Based on the quality of students, we reasonably arranged thetraining course content and enhanced the training of clinical skills; and at the same time focused on teacher training of general practitioners to strengthen the training bases, so as to improve the overall construction of teaching effect, to adapt to the actual medical need of the community and improve community medical service level to achieve the purpose of general practitioners training.

Objective To investigate the effects of ribs in high intensity focused ultrasound (HIFU)beam path on formation of coagulative necrosis in cattle liver in vitro in the same acoustic power. Methods The HIFU ablation was carried out in the manner of a single dot in the liver in vitro. The liver was ablated by HIFU in free field,then the ribs were placed between the focal plane and transducer,directing the beam axis through the intercostals space, lied at the rib edge and on the centre of middle rib. For each of these axial arrangements,the plane of the front surface of ribs was placed 3 cm,6 cm or 9 cm in front of the focus. After HIFU exposure,the tissue necrosis rate(TNR),the maximum length,width,depth and position of the coagulated necrosis in the liver were measured. Results ①The TNR was 100% in the free field. When the ribs were placed 3 cm in front of the focal plane,directing the beam axis through the intercostals space, the TNR was 100%. When directing the beam axis lied at the rib edge and on the centre of middle rib,the TNR decreased sharply. When the ribs were placed 6cm and 9cm in front of the focal plane, the TNR was more than 50%. ②When the ribs were placed in HIFU beam path, the volume of necrosis decreased compared with those in free field. The relationship between the ribs and beam axis, the location of ribs placed away from the focal plane different,the volume,length,width and position of the coagulated necrosis different. ③ When the ribs were close to the focal plane,unacceptable damage could been observed on the surface of ribs.When the ribs were far away from the focal plane, the ribs were safe. Conclusions The volume of necrosis decrease when the ribs are placed in HIFU beam path. The relative location of ribs and HIFU beam axis, the location of ribs away from the focal plane are relative with the volume of the coagulated necrosis. When directing the beam axis through the intercostals space, the volume of necrosis is large, and the shape of coagulated necrosis is regulated. When the ribs are closed with the focal plane,ribs are damaged probably.

In the 40 years of last centry American scientists put forward a concep of high intensity focused ultrasound (HIFU) therapeutic technique and had done some technical and clinical studies. Since 90 years the HIFU surgery technique treating tumors anew rised abruptly in the world. China firstly put out a comprehensive HIFU tumor treating sistem and successfully treated many solid tumors such as breast cancer, bone tumor, liver cancer etc.. Now the treating sistem has already exported to England, Italy,Spain, Japan, Colea etc. and treated tens thousands tumor patients. In the field of noninvasive ultrasound treating tumor technique China has continually kept the leading position in the world.

High intensity focused ultrasound (HIFU) is a new and exciting medical treatment. Cavitation is the focus in the field of HIFU research. Cavitation and the relationship between cavitation, echo and the thermal effects of HIFU treatment were reviewed in this article.