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.

It remains controversial whether tumor necrosis factor (TNF)-α antagonism is effective for asthma. This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma. MEDLINE, EMBASE, LILACS, and CINAHL databases were searched for English-language studies published through January 3, 2010. Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected. For each report, data were extracted in relation to the outcomes analyzed: asthma exacerbation, asthma quality of life questionnaire scores, and forced expiratory volume in 1 second. Four assessable trials were identified including 641 patients with asthma. TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52 (95% confidence interval 0.29-0.88), P=0.02]; however, there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23 (0 to 0.47), P=0.05], forced expiratory volume in 1 second [0.03, (-0.14 to 0.10), P=0.74] when analyzed using standardized mean differences. TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation, but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.

Objective To evaluate the effect of clinical pathway in pulmonary thrombus embolism (PTE) .Methods 60 cases of PTE were admitted department of respiratory from 2011 to 2012 and divided into the experimental group and the control group ,30 cases for each group .The control group was implemented with normal process of hospital management while experimental group de-veloped clinical pathways .The efficacy ,department of respiratory drug costs ,complications and patient satisfaction were recorded and computed .Results The average department of respiratory and drug costs in experimental group respectively was (17 .13 ± 2 .22)days ,(16 545 .04 ± 1 557 .44) RMB and (7 050 .83 ± 372 .74) RMB ;less than (19 .77 ± 3 .41)day ,(17 709 .45 ± 1 902 .05) RMB and (7 345 .75 ± 450 .82) RMB in control group ,there were significant difference between the two groups (P<0 .05) .The satisfaction scores of experimental group and the control group respectively were (93 .47 ± 3 .88)sores and (90 .90 ± 5 .30)scores , there was significant difference between the two groups (P<0 .05) .The therapeutic effect and complication rates between experi-mental group and control group were no significant difference (P>0 .05) .Conclusion The effect of clinical pathway in PTE have a positive role in reducing hospitalization time ,total costs ,drug costs and increasing satisfaction ,it is worth to develop in primary hos-pital .

Objective To investigate the feasibility of enhancing therapeutic effects on goats' liver in vivo treated by high intensity focused ultrasound(HIFU)combined with microbubble contrast agent SonoVue.Methods Fifteen Nanjiang goats were adopted,own control was adopted in this study.One group received purely HIFU therapy(control group),another one was radiated with HIFU combined with SonoVue contrast agent(SonoVue group).The HIFU irradiating mode was dotted with 30 mm focal length and 150 W,250 W,350 W acoustic power respectively,and the exposure time was 15 s.Animals were sacrificed and dissected 24h later,and the sizes of necrotic region were measured.Specimens were collected for histological inspection.Results Under the same parameter of exposure,the maximum length,width,depth,and the mean volume of the tissue coagulated by HIFU in the SonoVue group were all significantly greater than those in control group(P＜0.05),the change of volume coagulated tissue was much more significant with the increase of the acoustic power.The energy effciency factor (EEF)of SonoVue group was significantly smaller than that of control group(P＜0.05).The demarcation line between the necrosis and normal region was clear and the necrosis was complete,no living cell.The boundary exist amount of bubbles.Conclusions The therapy of HIFU combined with microbubble eontrast agent can substantially enhance the biological effects of the treatment and improve the efficiency of HIFU therapy on goats liver.

Objective: To investigate the effects of cadmium exposure on cardiovascular system of occupational workers. Methods: Cross-sectional study was applied to 992 workers in a nickel-cadmium battery plant in November, 2011, of which 749 were cadmium exposed workers and 243 were controls without cadmium and other expose. Urinary cadmium、electrocardiogram (ECG) and blood pressure were examined simultaneously among 992 workers. The risk factors of ECG abnormality rate and hypertension rate were analyzed by Logistic regression. Results: The level of urinary cadmium in cadmium exposed workers was significantly higher than controls (8.89±4.00 vs 1.34±1.18 μg/g creatinine, P<0.01) . Urinary cadmium level in women was significantly higher than men in both exposure and control group (P<0.05) . According to the group of working years, Urinary cadmium level raised with the increase of working years (F=28.272, P<0.001) . The ECG abnormality rate and hypertension rate of cadmium exposed workers were higher than that of control group, the differences were all statistically significant (P<0.01) . The abnormal rate of ECG and the hypertension rate increased with the prolonging of working years and demonstrated dose-response relationship. With the increase of urinary cadmium level, the abnormal rate of ECG and hypertension rate raised (OR=1.11, P<0.01) and (OR=1.15, P<0.01) respectively. Conclusion Occupational cadmium exposure increased the abnormal rate of ECG and blood pressure and therefore damaged cardiovascular system of workers. This study provided base data for protecting health of cadmium exposed workers.

It remains controversial whether tumor necrosis factor (TNF)-α antagonism is effective for asthma.This meta-analysis was performed to evaluate efficacy of TNF-α antagonism in treatment of patients with asthma.MEDLINE,EMBASE,LILACS,and CINAHL databases were searched for English-language studies published through January 3,2010.Randomized-controlled trials comparing TNF-α antagonism with control therapy were selected.For each report,data were extracted in relation to the outcomes analyzed:asthma exacerbation,asthma quality of life questionnaire scores,and forced expiratory volume in 1 second.Four assessable trials were identified including 641 patients with asthma.TNF-α antagonism therapy was superior to control therapy in preventing exacerbations in asthmatics [pooled odds ratio 0.52 (95％ confidence interval 0.29-0.88),P=0.02]; however,there was a nonsignificant reduction in asthma quality of life questionnaire scores [0.23 (0 to 0.47),P=0.05],forced expiratory volume in 1 second [0.03,(-0.14 to 0.10),P=0.74] when analyzed using standardized mean differences.TNF-α antagonism was superior to control chemotherapy in terms of asthma exacerbation,but not asthma quality of life questionnaire scores or forced expiratory volume in 1 second.

Objective:To summarize and analyze the early clinical outcomes of aortic endovascular remodeling device (AERD) for single-stage complete repair of acute aortic dissection.Methods:A total of 19 patients with acute aortic dissection who underwent proximal aortic dissection repair combined with distal AERD implantation at the Center for Aortic Surgery of Beijing Anzhen Hospital, Capital Medical University between May 2023 and October 2023, of whom 6 had type A aortic dissection and 13 had type B aortic dissection, were retrospectively analyzed. One-month postoperative follow-up and aortic CTA were completed to compare pre- and postoperative abdominal branch outcomes and aortic wall remodeling.Results:The success rate of AERD implantation in this patient cohort was 100%, and no complications such as paraplegia or visceral ischemia were observed during the perioperative and postoperative follow-up periods. All abdominal branches were patent postoperatively, and 15 branches had preoperative " high-risk" subtype malperfusion, 14 of which improved postoperatively. All patients showed significant increase of the true lumen volume compared with the preoperative one, and 89.5% (17/19) had a postoperative true lumen/overall volume ratio of more than 70%.Conclusion:The single-stage complete repair of proximal aortic dissection repair combined with distal AERD implantation is simple, safe and effective, associated with satisfactory early outcomes.

Objective:This study aims to summarize the pathological anatomy characteristics of residual aortic dissection (RAD) in patients with acute aortic dissection (AAD) during the perioperative period by measuring and analyzing the preoperative and postoperative 60-day computed tomography angiography (CTA) images of the aorta, with the intention of guiding further clinical treatment.Methods:A retrospective cohort study design was adopted. A total of 224 patients hospitalized with acute aortic dissection from December 2021 to October 2022 at a single center were included according to inclusion and exclusion criteria and divided into two groups based on Stanford classification. Computed tomography angiography (CTA) images of the aorta during the perioperative period (preoperative or postoperative 60 days) were collected, and relevant indicators were measured to describe the pathological anatomy characteristics of residual aortic dissection.Results:Among the measured range, there were 4 patients (1.8%) without distal tears, with a total of 648 identified distal tears. The numbers of tears in the A, B, and C segments were 211 (32.6%), 203 (31.3%), and 234 (36.1%), respectively. The average numbers of tears in the A, B, and C segments were 0.9±1.1, 0.9±0.9, and 1.0±1.2 per person, respectively. The corresponding average tear areas were(34.9±46.7)mm 2, (29.0±30.5)mm 2, and(18.6±23.9)mm 2, respectively. The average distances from tears to the upper and lower edges of the celiac trunk were(36.8±33.2)mm and(2.3±3.8)mm, respectively; to the upper and lower edges of the superior mesenteric artery (SMA) were(2.3±4.1 )mm and(1.2±2.6) mm, respectively; to the upper and lower edges of the left renal artery were(0.1±0.6) mm and(38.5±24.4) mm, respectively; and to the upper and lower edges of the right renal artery were(0.7±2.6) mm and(8.1±17.3) mm, respectively. True lumen blood supply for the celiac trunk was observed in 151 cases (67.4%); dual luminal supply in 49 cases (21.9%); and false lumen supply in 24 cases (10.7%). True lumen blood supply for the SMA was observed in 187 cases (83.5%); dual luminal supply in 32 cases (14.3%); and false lumen supply in 5 cases (2.2%). True lumen blood supply for the left renal artery was observed in 150 cases (67.0%); dual luminal supply in 27 cases (12.1%); and false lumen supply in 47 cases (21.0%). True lumen blood supply for the right renal artery was observed in 148 cases (66.1%); dual luminal supply in 30 cases (13.4%); and false lumen supply in 46 cases (20.5%). True lumen blood supply for both renal arteries was observed in 83 cases (37.1%); dual luminal supply in 4 cases (1.8%); and false lumen supply in 1 case (0.5%). Conclusion:The results of this study suggest that the average number of distal tears per person in patients with AAD is 2.9±1.9, with only 1.8% of patients having no distal tears. The average tear areas in the A, B, and C segments are(34.9±46.7) mm 2, (29.0±30.5) mm 2, and (18.6±23.9) mm 2, respectively. 61.2% of patients have tears in the abdominal aortic branch segment, and the tears are located at the same level as the abdominal aortic branches. Among the branches of the abdominal aorta, the renal arteries are most commonly affected by dissection, while the SMA is least affected. This study elucidates the anatomical basis for the limitations of existing repair methods and provides a theoretical basis for the design of subsequent repair techniques.