The history of Western Pacific Region Index Medicus (WPRIM), and advances in its journal selection, retrieval service platform construction and data acquisition were described.The daily record of users showed that WPRIM is of certain international influencing power, but is not a matured regional international index medicus. Suggestions were put forward for its popularization, project development funds, journal review and data acquisition.

Objective To evaluate the advantages of MR LAVA multi-phase dynamic contrast enhancement in abdominal MRI.Methods 42 cases which clinically suspected liver lesions and 15 normal volunteers underwent MRI examination,including routine T_1WI and T_2WI scan,T_1W 2D and 3D FSPGR,LAV A multi-phase contrast enhancement.The detecting rates of 2D,3D and LAVA images were analysed and the signal noise ratio(SNR)of the liver and spleen was observed.Results 68 lesions were detected by LAVA sequence,the detecting rate was 100%,the accurate rate of diagnosis was 95.6%(65/68),while the detecting rates of the lesions were 91.2%(62/68)and 89.7%(61/68)with 3D T1W FSPGR and 2D T1W FSPGR,respectively,the accurate rates in diagnosing the lesions were 76.5%(52/68)and 70.6%(48/68)with 3D and 2D sequences,respectively.The SNR of liver,spleen of 15 normal volunteers were:29.68±2.31 in liver,36.21 ±3.67 in spleen at LAVA plain scan,46.21 ±5.32 in liver,58.75±4.68 in spleen at 2D T_1W FSPGR,19.79±2.23 in liver,23.63±2.14 in spleen at 3D T_1W FSPGR,41.75±5.13 in liver,57.96±6.13 in spleen at LAVA contrast enhancement,56.33±5.63 in liver,63.21±5.32 in spleen at 2D contrast enhancement,29.05±4.68 in liver,46.37±5.17 in spleen at 3D contrast enhancement sequence.Conclusion LAVA multi-phase dynamic contrast enhancement is more predominant than T1W 2D and 3D and 3D FSPGR in displaying the lesions and blood vessels of liver.

Objective To evaluate the advantage of video-assisted mini thoracotomy for patients with esophageal cancer compared with routine open thomcotomy.Methods Perioperative clinical results were compared between 24 csses received VAMT(test group)and 26 cases underwent routine open thoracotomy(control group)during the same period.All the cancer stages were T2-3N0-1M0.Results This study showed that VAMT Was a minimally invasive swgew with shorter operation time(40.0±3.3)min vs.(70.3±3.2)min,P＜0.05)and had less bleeding volume both during and after operation compared to the control group(108.1±15.2)ml V8.(200.1±11.3)ml,(380.8±45.4)ml vs.(780.1±52.2)ml,P＜0.05).No significant differences were observed in the two groups with respect to complication occurrence rate(4.2%vs.19.2%,P＞0.05).Conclusion It is suggested that VAMT is safe,reliable and less invasive in the treatmem of esophagus carcinoma.

Objective To evaluate the effect of intravenous Gd-DTPA on 3.0T proton MR spectroscopy (MRS) water suppression and shimming. Methods Prospective study of proton MRS was performed with GE Signa Excite HD 3.0T system and eight-channel phased-array coils with PRESS sequence (head, liver and kidney, respectively). Routine auto prescan program was operated to record full width half maximum (FWHM) and water suppression (WS%). Routine scan was performed after injection of Gd-DTPA, then prescan program was reoperated to record FWHM and WS%. The data of FWHM and WS% in head, liver and kidney were compared between before and after injection of Gd-DTPA with the Wilcoxon matched pairs signed test. Results WS% of spectroscopy of head and liver after administration of Gd-DTPA decreased significantly (T_+=12, T_-=66, P=0.02; T_+=0, T_-=45, P=0.007). The effect of shimming of kidney after administration of Gd-DTPA was poor (T_+=0, T_-=435, P<0.001) and WS% of spectroscopy of kidney after administration of Gd-DTPA decreased significantly (T_+=0, T_-=435, P<0.001). Conclusion WS% of spectroscopy in head, liver and kidney can be impacted negatively by Gd-DTPA. Gd-DTPA has great influence on shimming of spectroscopy of kidney, but has little influence on shimming of spectroscopy of head and liver. It is better to acquire MRS data before administration of contrast medium in kidney.

Objective To observe the effect of full width half max (FWHM) on spectra signal-to-noise ratio (SNR), NAA/Cr, Cho/Cr and water suppression at 3.0T MR. Methods GE Signa Excite HD 3.0T MR scanner with 8 channel phrased-array head and neck coil was used. The respective study of liver 1H-MRS was performed using PRESS sequence. A total of 49 spectrums were obtained with parameters of TR 1500 ms, TE 30 ms, NSA 128. FWHM and water suppression were recorded automatically and the subjects were divided into better shimming group (FWHM<10 Hz) and worse shimming group (FWHM≥10 Hz). Independent t test was used to analyze the Cr_SNR, NAA/Cr, Cho/Cr, water suppression and volume of interest (VOI). Results Compared with worse shimming group, better shimming group could provide better Cr_SNR (t=5.976, P<0.001), higher NAA/Cr (t=2.469, P=0.017), lower Cho/Cr (t=-4.460, P<0.001) and smaller VOI (t=3.862, P<0.001). Conclusion When single voxel proton spectroscopy of head is adopted with 3.0T MR, small VOI is easy to achieve effective shimming, and better shimming is helpful to improve SNR, the ratio of main metabolites as well as water suppression.

ObjectiveTo observe the effect of acupuncture plus rehabilitation training on the function recovery of patients with post-stroke depression.MethodNinety-eight patients with post-stroke depression were randomized into two groups to receive conventional management and anti-depressants. The control group was intervened by sham-acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training, while the observation group was by acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training. Prior to the intervention and after 8-week treatments, the depression state, motor function and activities of daily life (ADL) were evaluated by using Hamilton Depression Scale (HAMD), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI). The indexes and quality of life were also determined during the 3-month follow-up study.ResultBefore intervention, there were no significant differences in comparing HAMD, FMA and MBI scores (P>0.05). After 8-week treatment, the HAMD, FMA and MBI scores were significantlyimprovedin both groups (P<0.01,P<0.05). After treatment, the HAMD, FMA, and MBI scores in the observation group were significantlydifferent fromthat in the control group (P<0.01,P<0.05). The total effective rate was 90.0% in the observation group versus 79.2% in the control group, and the difference was statistically significant (P<0.05). The 3-month follow-up study showed significant differences in comparing the indexes between the two groups (P<0.05, P<0.01).ConclusionAcupuncture plus rehabilitation training benefits the improvement of depression state, motor function, cognitive function and quality of life in patients withpost-stroke depression, and is worth promotion.

Objective To explore the feasibility,necessity and the skill of total mesoesophageal excision (TME ) during thoracoscopy combined with laparoscopy in radical resection of esophageal carcinoma.Methods 69 patients with esophageal carcinoma were divided into the TME group(40 cases)and the thoracotomy with triple incisions group(29 cases)according to the admission sequence.The operation time,intraoperative blood loss,total lymph nodes removed,postoperative complication rate and disease -free survival were compared between the two groups.Results The operation time of TME group was (182.85 ±26.73)min,which was significantly shorter than (295.71 ±19.50)min of the thoracotomy group (t=-19.301,P<0.001).The intraoperative blood loss in TME group was (86.43 ±59.34)mL,which was significantly less than (163.47 ±58.82)mL in the thoracotomy group (t=-5.342,P<0.001 ).No significant differences were detected between the two groups in total lymph nodes removed and incidence rate of postoperative complication (all P>0.05 ).The disease-free survival period in TME group was (14.78 ±2.14)months,which in the thoracotomy group was (13.10 ±4.09)months,the difference was significant (t=2.200,P<0.05).Conclusion TME is safe and feasible during thoracoscopy combined with laparos-copy in radical resection of esophageal carcinoma.TME is better in improving the regional control in esophageal carci-noma.

Objective To investigate the dose-effect relationship between Q-switch ruby laser and skin pigmentation in Guinea pigs. Methods Ten Guinea pigs were included in this study, and the back of each pig was divided into 5 areas, negative control area receiving no UVB irradiation or laser treatment, positive control area receiving UVB irradiation but no laser treatment, low-, middle- and high-dose areas receiving UVB irradiation followed by the treatment with laser at an energy density of 1.5, 3.0 and 6.0 J/cm2 for 4, 2, and 1 session, respectively, with an interval of 1 week. Melanin content index (MCI) was determined, and confocal laser scanning microscopy (CLSM) and histopathology were performed to observe melanin granules and melanocytes in the skin tissue from Guinea pigs before the initial laser treatment, 2 and 4 weeks after the final laser treatment. Results The best response was observed in the low-dose areas, and there was a complete clearance of hyperpigmentation in these areas, which maintained 8 weeks without recurrence, while different degrees of skin pigmentation recurred in the middle- and high-dose areas. Moreover, the low-dose areas showed a significantly lower melanin content index (MCI) compared with the middle- and high-dose areas (F = 4.2,P < 0.05), together with a marked reduction in the extent of pigment deposition, melanin granules, melanocyte number and density. Conclusions The efficacy of Q-switched ruby laser on skin pigmentation in Guinea pigs is correlated with the energy density and treatment frequency, and, low intensity and high frequency are often associated with a better treatment outcome.

ObjectiveTo compare the accelerating effect of topical recombinant human epidermal growth factor (rhEGF) and recombinant bovine basic fibroblast growth factor (rb-bFGF) on wound healing after fractional CO2 laser therapy.MethodsTwenty male guinea pigs were included in this study.After hair removal and irradiation with fractional CO2 laser,the back of each guinea pig was divided into 4 regions to be topically treated with rhEGF of 10 μg/cm2 (rhEGF group),rb-bFGF of 262.51 IU/cm2 (rb-bFGF group),the combination of rhEGF and rb-bFGF (combination group),or normal saline (control group),twice daily until the healing of wound.Skin physiology parameters including elasticity index and melanin index were detected before the irradiation,7,14 and 28 days after the irradiation,and compared between the 4 groups by analysis of variance.Tissue specimens were obtained from 4 mice at the above time points and subjected to pathological examination for the observation of collagen fibers and quantification of fibroblasts.ResultsAfter fractional CO2 laser therapy,the crusts fall off completely in growth factor-treated regions,while partly in the control regions,within 3 to 7 days; the wounds healed completely in 14 to 28 days in all the groups,with the regenerating tissue being more tender and redder compared with the surrounding unirradiated tissue.The wound surface was smaller in area and redder in color in the 3 growth factor-treated groups than in the control group.At 28 days after the irradiation,the elasticity index was 262.29 ± 62.40 in the combination group,202.00 ± 65.62 in the rhEGF group,188.86 ± 35.02 in the rb-bFGF group,167.14 ± 42.49 in the control group.Statistical difference was observed in elasticity index,but not in skin melanin index among the 4 groups.Pathological examination showed a dense and organized arrangement of collagen fibers in the combination group but a sparse and disorganized arrangement of collagen fibers in the control group.ConclusionThe combined application of rhEGF and rbbFGF can accelerate the healing of wound and increase the elasticity of regenerating tissue after fractional CO2 laser therapy.

Objective To investigate the significance of preoperative and postoperative enteral nutrition support in gastric cancer patients with nutritional risk.Methods The clinical data of 72 gastric cancer patients with nutritional risk admitted in our department were analyzed.All the patients were randomly allocated into two groups.36 patients in the control group received only intravenous nutrition postoperatively (PN group).36 patients in the treatment group received enteral nutrition support from the fifth day before operation to eighth day after operation (EN group).The body weight,total protein,albumin,transferrin and prealbumin were measured on the fifth day before operation,the operation morning,the first day and the eighth day after operation.Results On the operation morning,the transferrin and prealbumin of the EN group were higher than those in PN group significantly(P ＜0.05).In the eighth day after operation.the treatment group patients showed significant increase in the body weight,total protein,albumin,transferrin and prealbumin compared with those in the control group(P ＜ 0.05).On the operation morning,the transferrin and prealbmnin of EN group were increased significantly than on the fifth day before operation(P ＜ 0.01).Conclusion The preoperative and postoperative enteral nutritional support can improve the nutritlonal condition in the gastric cancer patients with nutritional risk.The preoperative enteral nutritional support can improve the patients' nutritlonal condition and reserves before operation,and reduce adverse reaction of enteral nutrition.