Purpose To evaluate the relative bioavailability of a domestic sustained-release metformin tablets (SRM) compared against an immediate-release metformin tablets (IRM) using a multiple-dose,two-way crossover design after a single-dose study. Methods Eighteen healthy adult male volunteers,aged 18 to 22 years (mean,20 years),weighing 55 to 76 kg (mean,64 kg) and with height ranging from 166 to 180 cm (mean,173 cm),and blood glucose levels from 4.0 to 5.9 mmol/L (mean,4.3 mmol/L) participated in the study.The concentrations of metformin in plasma were determined using a ion-pair liquid chromatographic method. Results In single-dose study,the mean residence time (MRT),Tmax,and apparent elimination half-life (T1/2) for SRM were significantly longer and Cmax significantly lower than the corresponding values determined for IRM.The similar results were also demonstrated in multiple-dose study.The mean values of the relative bioavaibility of SRM compared with IRM in two administration ways were (85.95±0.97)% and (86.44±7.88)%,respectively.The single-dose and multiple-dose administration of the 90% confidence interval for the ratio of the logarithmic transformed AUC values of SRM over those of IRM were calculated to lie between 0.83 and 0.88,0.83 and 0.89,respectively,being within the acceptable bioequivalence limit of 0.80～1.25. Conclusion SRM was of the characteristic of sustained-release pharmacokinetics.The relative bioavailability for single dosing was similar to that of multiple dosing,and both of the administration ways demonstrated bioequivalence in absorption between SRM and IRM.

ObjectiveTo explore the sonographic features of gouty arthritis.MethodsThe sonographic features of gouty arthritis were summarized by retrospectively studying the sonogram of 19 joints of 5 patients.ResultsFive the first metatarsophalangeal joints,8 knees,2 ankles,2 elbows and 2 wrists were investigated.Out of 19 joints,17(89.4％) had double contour signs,a hyperechoic and irregular band over the superficial margin of the articular cartilage.Joint effusions were seen in 13 of 19 joints (68.4％).Multiple hyperreflective foci could be seen in the joint fluid,which were obvious by shaking the probe.In 19 joints,11 (57.9 ％) had proliferation of the synovium identified,and proliferative synovium were revealed as hyperperfusion or hypoperfusion by color Doppler ultrasound.In one knee,the synovium proliferated obviously with involved area about 5 cm × 2 cm,and hyperechoic aggregates with acoustic shadow could be seen in it.Articular cartilage became irregularly thin and the hyperechoic outline of subchondral bone cortex became rough or even broke in 6 of 19 joint (31.6％).H omogeneous,hyperechoic aggregates with or without acoustic shadow in the soft tissue around the joint were seen in four joints (21.1 ％).Three in these 4 joints exited bone cortex erosions adjacent to aggregates.ConclusionsGouty arthritis has some specific sonographic features,ultrasound maybe usefully discover this disease in early period.

ObjectiveTo evaluate the value of uhrasonography for arthrocentesis in the hip and the advance of the femoral head/acetabulum as the puncture location in patients without sonographically obvious joint effusion.Methods Forty-three patients diagnosed with ankylosing spondylitis or osteoarthritis were included,82 hip joints were involved and received ultrasounded-guided intra-articular injections.The puncture site was the joint space between the femoral head and the acetabulum.The times,depth,procedure time,side effects and complications of each injection were recorded.ResultsAll 82 hips could be explicitly displayed.The depths from the skin surface to the joint space were (3.4 ± 0.9)cm (left)and (3.1 ± 0.8)cm (right),respectively.Overall,100％ of hip joints were punctured successfully,and 95.1％ of them were succeeded with the first arthrocentesis.The procedure time was (287.9 ± 45.8) s.No side effects or complications were observed.ConclusionsThe sonographic technique could be used as a primary method of image guidance for performing hip arthrocentesis and the joint space between the femoral head and the acetabulum could be a choice of target location for the patients without joint effusion.

Objective To evaluate the charateristics of biliary stricture after orthotopic liver transplantation(OLT) by ultrasound. Methods Diametes,thickness,characteristic echo of bile were observed by ultrasound in 41 patients with biliary stricture after OLT,and the results were compared with those of 46 patients without biliary complication after OLT.Results The diameter of intrahepatic bile,thickness of bile,incidence of intrahepatic bile dilation or hyperechogenicity in biliary stricture patiens were higher than those in patients without biliary complication,there were significant differences between two groups(P＜0.05).Conclusions The series of ultrasonographic character such as bile dilation,thickeness or hyperechogenicity of biliary wall,thin of bile duct are available to diagnose biliary stricture.

Objective To compare the value of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (CUS) in the localization and definition of different types of uterine myomas.Methods With real-time CEUS technique, 56 patients with uterine myomas proved by pathology were observed. The accuracy between CEUS and CUS in the localization and definition of different types of uterine myomas was retrospectively analyzed. Results The accordance rates of CEUS and CUS in the diagnosis of total uterine myomas, intramural myomas, submueous and subserous myomas were 94.6% (53/56) vs 73.2%(41/56),99.3%(31/32) vs 78.1%(25/32) and 91.6%(22/24) vs 66.7%(16/24),respectively,and in the definition of number and margin of myomas were 92.8 % (104/112) vs 80.30% (90/112) and 91.9 (103/112) vs 78.6 % (88/112). The accordance rates of CEUS and CUS in the diagnosis of typical uterine myomas were 95.8% (23/24) and 87.5% (21/24),and in the diagnosis of atypical uterine myomas were 93.8%(30/32) and 62.5% (20/32),which were different in statistics (P<0.05). Conclusions CEUS is better than CUS in revealing the number and margin of different types of uterine myomas. The accordance rates of CEUS were higher than those of CUS in the diagnosis of different types of uterine myomas and atypical uterine myomas. CEUS may be a new technique in the localization and definition of uterine myomas.

Objective To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of subserous myoma (SM) and ovarian fibroma.Methods CEUS was performed on 58 patients with SM and 26 patients with ovarian fibroma.The enhancement pattern was observed.The diagnostic performance was evaluated by using diagnostic test.Results SM exhibited homogeneous isoenhancement synchronously with the myometrium in early phase.In the late phase,the pseudocapsule remained hyper-enhancement with obvious membraniform sign.Some myomas showed the feeding artery from uterus.Ovarian fibroma demonstrated hyper-enhancement at the periphery portion and hypoenhancement inside.Conclusions The SM and ovarian myomas showed different enhancement patterns,which may provide us some exact information in the differential diagnosis between the two diseases.

Objective To evaluate the feasibility and accuracy of the transvaginal real-time three-dimensional hysterosalpingo-contrast sonography(RT 3D-HyCoSy) with SonoVue in the assessment of tubal patency.Methods Tubal patency was investigated by RT 3D-HyCoSy in 96 unselected infertile patients (a total of 191 tubes).The image quality of RT 3D-HyCoSy was evaluated.Laparoscopy was performed in 35 cases (a total of 70 tubes) of them.The efficacy of the procedure was compared with laparoscopy.Results The mean score of image quality of RT 3D-HyCoSy in ninety-six cases was 2.94 ± 0.26.The accordance between RT 3D-HyCoSy and laparoscopy was good,with the Kappa value was 0.802.Sensitivity,specificity,positive predictive value,negative predictive value and accuracy in diagnosing tubal patency by using RT 3D-HyCoSywas 87.5％ (14/16),94.4％ (51/54),82.3％ (14/17),96.2％ (51/53),92.9％ (65/70),respectively.Conclusions Transvaginal RT 3D-HyCoSy is a good imaging technique which can display the morphological character of fallopian tube and assess the patency.

ObjectiveTo assess the diagnostic performance of contrast-enhanced ultrasound(CEUS)in characterization of adnexal masses in comparison with baseline ultrasound.MethodsOne hundred and thirty-seven masses were examined by CEUS and baseline ultrasound.Two independent investigators reviewed the images before and after contrast agent administration.The diagnostic performances were evaluated using receiver operating characteristic (ROC) analysis and the interobserver agreement was analyzed.ResultsAfter review of CEUS,ROC analysis revealed significant improvement in differentiating between malignant and benign pelvic masses that the areas under the ROC curve were 0.731 and 0.738 at baseline ultrasound versus 0.891 and 0.903 at CEUS ( P ＜0.01 ).The accuracy for both investigators also improved significantly after reviewing CEUS.A better interobserver agreement was achieved after reviewing of CEUS (g =0.681 at baseline ultrasound versus κ =0.893 at CEUS) and a better result of specific diagnosis was obtained (73.2％ and 74.2％ at baseline ultrasound versus 90.7％ and 91.2％ at CEUS)(all P ＜ 0.01 ).Conclusions Real-time CEUS improves the diagnostic performance in adnexal masses for discrimination between malignancy and benignity and improves the capability in specific diagnosis compared with baseline ultrasound.

Objective To assess the diagnostic performance of contrast-enhanced ultrasound in characterization of pelvic masses.Methods Contrast-enhanced ultrasound was performed on 137 patients with pelvic masses.The results were compared to pathological diagnostic criteria.The diagnostic performance was evaluated by using diagnostic test.Results Sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under ROC curve in diagnosing complex pelvic masses by using contrast-enhanced ultrasound were as follows:85.3％ (29/34),93.2％ (96/103),80.6％ (29/36),95.0％ ( 99/101 ),91.2％ ( 125/137 ),0.892,respectively.Conclusions Contrast-enhanced ultrasound provides a simple and curate method for characterization of pelvic masses.

BACKGROUND: Spondyloarthropathies(SpA) are a group of interrelated disorders that involve the spine, peripheral joints, and tissues around or outside the joints. SpA are most common in young males, and both the incidence and the mutilation rate are very high. It is important to evaluate the disease activity of patients with SpA since the evaluation can help in therapeutic selection and prognostic prediction of SpA. But up to now there still has not been a widely clinically acceptable criterion to evaluate the disease activity of SpA.OBJECTIVE: To study the worth of color Doppler(CD) in assessing the disease activity of patients with SpA.DESIGN: Non-random and self-control clinical study based on the patients.SETTING: All patients recruited in this study were from department of rheumatology of the Third Affiliated Hospital of Sun Yat-sen University. And all the ultrasonic examinations were conducted in the department of ultrasound of the same hospital.PARTICIPANTS: Thirty(24 males and 6 females) patients with SpA who met the European SpA Study Group criteria for the classification of SpA issued in 1991 and consented to be examined by CD were included.METHODS: CD was used to determine the blood perfusion at 18 major entheses of lower limbs of each patient with a semi-quantitative method. Blood sample was also taken from the patients for the examination of erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) . The disease activity of the patients was also evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).MAIN OUTCOME MEASURES: To observe the inter-correlations between entheseal blood perfusion, ESR, CRP and BASDAI.RESULTS: 80% of the 30 patients were detected to have positive perfusion in at least one enthesis of the 18 examined entheses, and all together 84 entheses were found to have positive perfusion among the 540 entheses being detected(positive rate 15.6% ) . The sum of entheseal perfusion detected in all the 18 sites was statistically correlated with the sum of patients' ESR,CRP, BASDAI respectively with the correlation coefficients of 0. 658, 0. 428and 0. 821 (all P ＜ 0.05) . ESR and CRP were also statistically correlated with BASDAI and their correlation coefficients were 0. 675 and 0. 368(Both P ＜ 0.05) . The sum of perfusion detected in the 18 entheses sites was correlated with BASDAI better than ESR or CRP was.Detecting the.entheseal perfusion by CD can help to determine the disease activity of patients with SpA, and then to guide selecting therapeutic strategy. It is also important for following up and prognosis.