Objective To evaluate the clinical value of intraoperative image fusion assisted contrastenhanced ultrasound (CEUS) in real-time assessing the curative effect on radiofrequency ablation of hepatocellular carcinoma(HCC).Methods From November 2010 to August 2011,the patients with HCC which would accept radiofrequency ablation (RFA) in our hospital were divided into image fusion assisted CEUS group and conventional CEUS group.The HCC lesion in each group was named as difficult lesion if it was invisible in B-mode ultrasound,larger than 50 mm in diameter or the puncuture route was affected by lung,ribs or blood vessels.Ten minutes after RFA,two groups of patients were performed intraoperative image fusion assisted CEUS examination and conventional CEUS examination respectively.All the patients received CT/MRI one month after ablation to decide whether the HCC had been completely ablated.Difference of complete ablation rate of HCC was compared between the two groups as well as between the difficult lesions in each group.Results Forty-eight lesions in 39 patients were enrolled in image fusion assisted CEUS group including 19 difficult lesions.Sixty-eight lesions in 53 patients were enrolled in conventional CEUS group including 18 difficult lesions.No statistical difference was found between the two groups in lesion size,proportion of difficult lesions,proportion of lesions received TACE or RFA plus PEIT (P =0.052,P =0.136,P =0.185,P =1.000).Postoperation following-up results demonstrated that complete ablation rate of HCC in navigation assisted CEUS group(100 ％,48/48) was not statistically higher than that in conventional CEUS group(92.6％,63/68) (P =0.145).But the difficult lesions in navigation assisted CEUS group (100％,19/19) had statistically higher complete ablation rate than that in conventional CEUS group(72.2％,13/18) (P =0.020).Conclusions Intraoperative navigation assisted CEUS could real-time assess the curative effect on RFA of HCC,especially in the difficult lesions,and could be used as the beneficial supplement of the conventional CEUS.

OBJECTIVETo study the effects of improving the neuromuscular transmission (NMT), "non-AChE-reactivating effects", by oximes in treating acute isocarbophos poisoning.

METHODSThe effect of pralidoxime chloride(PAM-Cl) on the neuromuscular transmission(NMT) in rats exposed to isocarbophos was studied by using the stimulation single fiber electromyography (SSFEMG) to determine the single fiber action potential.

RESULTSAfter the rats exposed to isocarbophos were treated by PAM-Cl, the mean consecutive difference(MCD) value [(25.99 +/- 5.84) microsecond] of single fiber action potential was significantly lower than that before PAM-Cl treatment [(33.21 +/- 4.09) microsecond, (P < 0.01)], but no AChE reactivation in blood and gastrocnemius was observed.

CONCLUSIONPAM-Cl has "non-AChE-reactivating effects", it could markedly improve isocarbophos-induced NMT block of gastrocnemius.

Acute Disease ; Animals ; Antidotes ; pharmacology ; Cholinesterase Inhibitors ; poisoning ; Insecticides ; poisoning ; Malathion ; poisoning ; Neuromuscular Junction ; drug effects ; physiology ; Pralidoxime Compounds ; pharmacology ; Rats ; Synaptic Transmission ; drug effects

Objective To evaluate the clinical value of CT/MR-contrast enhanced ultrasound (CEUS) image fusion in immediate assessment for hepatocellular carcinoma (HCC)ablation.Methods Patients diagnosed with HCC to receive ablation therapy were randomly divided into two groups.The ablation for each patient was performed according to their pre-ablation plan.Immediate assessments for the ablation were performed using CT/MR-CEUS image fusion (IF group)and CEUS (CEUS group)separately and whether the need for additional ablations was decided and performed during the therapy.The therapy efficacy was evaluated with enhanced CT or MR 1 month after each complete ablation treatment.Results There were 101 patients with 131 nodules in IF group,and 15.1% of the nodules needed additional ablation according the immediate assessment during the therapy.The complete ablation rate of IF group was 99.2%(125/126).On the other hand,there were 93 patients with 122 nodules in CEUS group,and 4.2% of the nodules needed additional ablation according the immediate assessment during the therapy.The complete ablation rate of CEUS group was 94.2% (113/120).IF group has significantly higher additional ablation rate and complete ablation rate than CEUS group (P <0.05).Conclusions CT/MR-CEUS image fusion can further improve ablation efficacy with accurate intraoperative evaluation and guidance of additional ablation compared with CEUS.

Objective To explore the value of double contrast enhanced ultrasound (D-CEUS) in detection of periampullary lesions. Methods Clinical data of 43 patients with periampullary lesions who received examinations of D-CEUS and contrast-enhanced magnetic resonance imaging (MRI) both in the Third Affiliated Hospital of Sun Yat-sen University from July 2006 to December 2012 were analyzed retrospectively. The informed consents of all patients were obstained and the ethical committee approval was received. There were 29 males and 14 females with a mean age of (56±2) years old. There were totally 45 lesions in 43 patients, including 30 malignant lesions (13 duodenal papillary carcinomas, 7 distal common bile duct carcinomas, 6 pancreatic uncinate process carcinomas, 4 ampullary carcinomas) and 15 benign lesions which all were distal common bile duct stones. All the lesions were conifrmed by surgical pathological biopsy or choledochoscope. The detection rates of periampullary lesions and the display rates of relation between periampullary malignant lesions and surrounding tissues by D-CEUS and contrast-enhanced MRI were compared. The rates of 2 groups were compared by Chi-square test. Results Periampullary lesions could be displayed clearly both by 2 examination methods. The detection rate of periampullary lesions was 98%(44/45) by D-CEUS and was 96%(43/45) by contrast-enhanced MRI, where no signiifcant difference was observed (χ2=0.345, P>0.05). For the display of relation between periampullary malignant lesions and surrounding tissues, 77%(23/30) was well-deifned, 20%(6/30) was poorly-deifned, and 3%(1/30) was ill-deifned by D-CEUS, while it was 86%(26/30), 7%(2/30), 7%(2/30) by contrast-enhanced MRI accordingly, where no significant difference was observed (χ2=2.517, P>0.05). Conclusions D-CEUS has a high detection rate of periampullary lesions. Its detection ability is similar to contrast-enhanced MRI, and it can be an important supplement to, even a replacement for contrast-enhanced MRI.