ObjectiveTo investigate the relationships between traditional Chinese medicine(TCM) syndrome differentiation and serum cystatin C(Cys-C) and homocysteine(Hcy) in patients with chronic heart failure(CHF). Methods 115 cases with CHF admitted into the Department of Cardiology of the First Affiliated Hospital of Zhejiang Chinese Medical University were selected in the CHF group, and 30 cases who had taken health examination in the same period were chosen in the healthy control group. According to the TCM syndrome differentiation, the CHF cases were subdivided into four groups with different types of syndrome: 30 cases of deficiency of both Qi and Yin syndrome, 30 cases of Qi deficiency syndrome and blood stagnation syndrome, 30 cases of heart and kidney Yang deficiency syndrome and 25 casesof flooding due to Yang deficiency syndrome. The serum levels of Cys-C and Hcy in different groups were tested, and the relationships between TCM syndrome differentiation and serum Cys-C and Hcy were analyzed by using Spearman rank correlation analysis.Results The serum levels of Cys-C and Hcy in the patients with CHF were significantly higher than those in the healthy control group〔Cys-C(mg/L):1.24±0.34 vs. 0.77±0.22, Hcy(μmol/L):18.66±4.57 vs. 11.65±3.21,bothP<0.05〕. Compared with the healthy control group, the serum levels of Cys-C and Hcy in the above four groups of different syndromes had a tendency of gradual elevation in the sequence as follows: deficiency of both Qi and Yin, Qi deficiency and blood stagnation, heart and kidney Yang deficiency and flooding due to Yang deficiencygroups〔Cys-C(mg/L):1.02±0.27,1.09±0.31,1.32±0.22, 1.59±0.25; Hcy(μmol/L): 14.94±2.20, 17.66±3.04, 19.79±3.48, 22.96±5.31〕, and the elevation in levels of flooding due to Yang deficiency group was the most prominent compared with that in other groups(P<0.05). The correlation analyses showed that different types of TCM syndrome in patients with CHF were positively correlated with the levels of Cys-C and Hcy(r1=0.73,r2=0.79,bothP<0.05).ConclusionThe changes of serum Cys-C and Hcy levels are consistent with the evolution of regular pattern of TCM syndrome differentiation in patients with CHF, and these two markers can be regarded as the objective indicators of TCM syndrome differentiation of CHF.

Objective To evaluate the feasibility and efficacy of mono-modality fusion imaging using ultrasound in the intraoperative immediate evaluation of therapeutic response of liver cancer thermal ablation.Methods A total of 70 liver cancers in 53 patients that underwent thermal ablation from October to November 2015 were included in this study.Mono-modality fusion imaging using ultrasound was applied immediately after the ablation procedure to evaluate the therapeutic response of the thermal ablation.The applicable rate,the success rate of registration,the duration time,the evaluation results and the rate of supplemental ablation were recorded.Ultrasound examination was performed on the first day after ablation to evaluate the early complication.Contrast-enhanced CT/MR within 1-3 months after the procedure was regarded as the golden criteria of the treatment response.In the follow-up period,the rate of local tumor recurrence,progression-free survival and overall survival were analyzed.Results The applicable rate for mono-modality ultrasound fusion imaging is 62.9％ (44/70) while the success rate of registration is 90.9％ (40/44).The duration time for mono-modality is 2.7-7.5 min,with an average of (3.9 ± 0.9) min.Thirty-seven out of 40 liver cancers were evaluated to achieve safety margin and 3 out of 40 were not.The rate of supplemental ablation was 40％ (16/40).The rate of complete ablation was 97.3％ (36/37) according to contrast-enhanced CT/MR within 1-3 months.In the follow-up period,no local tumor recurrence was observed and the rates of intra-hepatic recurrence and overall survival were 46.7％ (14/30) and 96.7％ (29/30),respectively.Conclusions Mono-modality ultrasound fusion imaging is a convenient,feasible,safe and efficient method in the intraoperative immediate evaluation of therapeutic response of liver cancer thermal ablation.

ObjectiveTo investigate the subsequent therapy and its effect for local tumor progression (LTP) of primary liver cancer after thermal ablation.MethodsClinical data of 22 patients with LTP of primary liver cancer after thermal ablation in the Third Afifliated Hospital of Sun Yat-sen University between January 2008 and December 2012 were retrospectively analyzed. Among the patients, 17 were males and 5 were females with the age ranging from 38 to 77 years old and the median of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. A total of 30 lesions of LTP in the 22 patients were included in this study. The lesions were divided into the single treatment group (n=21) and the combined treatment group (n=9) according to the different subsequent therapies. Patients in the single treatment group were treated with single method of radiofrequency ablation (RFA) or microwave ablation, while patients in the combined treatment group were treated with transcatheter arterial chemoembolization (TACE) or percutaneous ethanol injection combined with RFA. Appropriate auxiliary means of thermal ablation, such as artiifcial pleural/peritoneal effusion, one-lung ventilation and ultrasonography were utilized in both groups. The complete ablation rate of tumor and complication incidence rate in two groups were compared. The rate was compared using Chi-square test or Fisher's exact probability test.ResultsSeventy-three percent (22/30) of the lesions were treated with auxiliary means. The complete ablation rate was 90% (19/21) in the single ablation group and 7/9 in the combined treatment group, and no signiifcant difference was observed between two groups (P=0.563). No serious complication was observed in two groups.ConclusionWith the application of various auxiliary therapies, single thermal ablation may achieve the therapeutic effect as good as the combined treatment for the LTP lesions of primary liver cancer after thermal ablation.

Objective To investigate the feasibility and accuracy of three-dimensional ultrasound-ultrasound(3DUS-US)fusion imaging based on electromagnetic positioning in the assessment of ablation zone of liver tumor through experimental study in phantom models.Methods Sixteen phantom models which could be ablated and used to assess the ablation zone were established.Then,they were ablated and divided into complete ablation group(n =8)and incomplete ablation group(n =8)randomly.Their ablation effects were assessed by 3DUS-US fusion imaging.If the tumor model was assessed as incomplete ablation,the maximum thickness of the residual tumor was measured.The assessments of gross specimen were used as golden standard to validate the feasibility and accuracy of assessment of 3DUS-US fusion imaging.The success rate of registration,duration time of fusion imaging,accuracy rate of assessment and measurement error in incomplete ablation group were recorded.Results All of the 16 phantom models were produced successfully.The success rate of registration was 100% and the duration time of 3DUS-US fusion imaging was(3.9±1.0)min.The accuracy rate of assessment was 100%.There was no significant difference between the assessment of residual tumor thickness in incomplete ablation group by 3DUS-US fusion imaging and gross specimen(t=-0.814,P =0.442),and the measurement error was(1.1±0.6) mm.Conclusions 3DUS-US fusion imaging based on electromagnetic positioning is a feasible,accurate and convenient method in the assessment of ablation zone of liver tumor.It would be a new immediate precise assessment method during ablation procedure for liver tumor.

Objective To evaluate the application value of fusion imaging in intraoperative instant curative effect evaluation of thermal ablation for primary liver cancer (liver cancer). Methods Forty-six patients with liver cancer (71 lesions in total) undergoing ultrasound-guided thermal ablation in the Third Afifliated Hospital of Sun Yat-sen University between December 2014 and March 2015 were recruited in this prospective study. Forty-two patients were males and 4 were females, aged between 36 and 82 years with a median age of 54 years. The informed consents of all patients were obtained and the local ethical committee approval was received. After thermal ablation, clinical efficacy was preferentially assessed by contrast-enhanced ultrasound (CEUS)-computed tomography (CT)/magnetic resonance imaging (MRI) fusion imaging technique for all liver cancer lesions. If the fusion imaging was not successfully performed, simple CEUS was utilized for evaluation. According to the evaluation methods, the patients were divided into the fusion imaging group and CEUS group. The lesion size, supplementary and complete ablation rates in two groups were observed. The lesion diameter between two groups was compared using Z test and the ratio was compared using Chi-square test or Fisher's exact probability test. Results Fusion imaging was utilized for instant curative effect evaluation in 25 patients with 31 lesions, and simple CEUS was used for evaluation in 26 cases with 40 lesions. In the fusion imaging group, 58%(18/31) of the lesions were≥20 mm in diameter, signiifcantly higher compared with 30%(12/40) in the CEUS group (χ2=5.638, P<0.05). The supplementary ablation rate in the fusion imaging group was 52%(16/31), signiifcantly higher than 22%(9/40) in the CEUS group (χ2=6.489, P<0.05). The complete ablation rate was 100%(31/31) in the fusion imaging group and 95%(38/40) in the CEUS group , and no signiifcant difference was observed (P=0.501). Conclusions Both fusion imaging and simple CEUS are important methods for intraoperative instant curative effect evaluation. Fusion imaging has higher accuracy for the relatively large lesions and help to enhance the complete ablation rate.

Objective:To explore the feature of FOS expression in oxytocin-and vasopressin-positive neurons in the hypothalamic paraventricular nucleus(PVN)under different status of diabetes mellitus(DM).Methods:Intraperito-neal injection of vehicle or STZ in mice was conducted to establish control or diabetes model.Mechanical sensitivity was evaluated by von Frey filament tests to distinguish diabetic neuropathic pain(DNP)from without-pain group(DWP).The expression of FOS,oxytocin(OXT)-and vasopressin(VP)-positive neurons,as well as their double labeling was detected by immunohistochemical and immunofluorescent staining.Cell counting and comparison were made in groups.Results:FOS expression was easily detected in the PVN in the three groups(Control group,DNP group and DWP group)at 7 days,while that in DWP and DNP groups at 28 days was hardly detectable,with the number being signifi-cantly different from the 7 days group(P＜0.05 or 0.001).Likewise,compared with the control group,immunofluo-rescent signals for VP and OXT staining in the DNP and DWP groups also showed a trend of weakening as the modeling time increased(P＜0.05).The cell counting after double staining for VP or OXT with FOS showed that,in the DWP group at 7 days,the number of VP and FOS double-labeled neurons was 74.33±22.10,accounting for(56.64± 7.52)％of VP-positive cells,whereas the double labeling rate for OXT and FOS was only(10.44±3.14)％.In the DNP group at 7 days,the number of OXT and FOS double-labeled neurons was 51.00±31.80,accounting for(18.50 ±9.51)％of OXT-positive neurons,whereas the double labeling rate for VP and FOS was only(9.34±3.27)％.In contrast to these changes in 7 days group,the expression of FOS decreased sharply in the group of 28 days,thereby al-most no double-labeled neurons.Conclusion:The plasticity changes of oxytocin-and vasopressin-positive neurons in the PVN are different depending on the status of pain and non-pain,and the stage of disease progression.Understanding the changes is of great significance for unravelling the neural mechanism of diabetes and its complications.

ObjectiveSerum metabolomics of acute lung injury（ALI） in rats was conducted using ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS） to explore the similarities and differences in the mechanism of Qingqiao（harvested when the fruits of Forsythiae Fructus were initially ripe and still green in color） and Laoqiao（harvested when the fruits of Forsythiae Fructus were ripe） in the treatment of ALI. MethodA total of 24 SD male rats were acclimatized and fed for 1 week， 6 of them were randomly selected for the blank group and 18 for the experimental group. The ALI model was induced in the experimental group by tracheal intubation with lipopolysaccharide（LPS）. After successfully constructing the ALI model， these rats was randomly divided into model group， Qingqiao group and Laoqiao group， with 6 rats in each group. The Qingqiao and Laoqiao groups were administered orally once a day at a dose of 1.5 g·kg^-1， while the blank and model groups received an equivalent volume of saline for 3 consecutive days. The pathological conditions of rat lung tissues were comprehensively assessed by hematoxylin-eosin（HE） staining， wet-to-dry mass ratio（W/D） of lung tissues， and protein concentration in rat bronchoalveolar lavage fluid（BALF）. The levels of interleukin（IL）-6， IL-1β and tumor necrosis factor（TNF）-α in BALF were quantified using enzyme-linked immunosorbent assay（ELISA）. UPLC-Q-TOF-MS was used to identify and analyze the chemical compositions of Qingqiao and Laoqiao， and serum metabolomics of rats in each group was analyzed， combined with multivariate statistical analysis with variable importance in the projection（VIP） value>1， P<0.05 from t-test， and fold change（FC）≥1.5 or FC≤0.5 to screen the differential metabolites Qingqiao and Laoqiao for the treatment of ALI. The Kyoto Encyclopedia of Genes and Genomes（KEGG） database was used in combination with MetaboAnalyst for the metabolic pathway analysis of the screened differential metabolites. ResultCompared with the blank group， rats in the model group exhibited enlarged alveolar lumen， ruptured alveoli， interstitial hemorrhage， bronchial exudation of a large number of neutrophils and erythrocytes， and a significant increase in the protein concentration in the BALF and the W/D value of the lung tissues（P<0.01）. In contrast， compared with the model group， rats in the Qingqiao group and the Laoqiao group showed reduced bronchial hemorrhage in the lungs， and the protein concentration in the BALF and the W/D value of the lung tissues were significantly decreased（P<0.01）， the lung injury was significantly alleviated， but more obvious in the Qingqiao group. Compared with the blank group， the expression levels of IL-6， IL-1β and TNF-α in the BALF of the model group were significantly higher（P<0.01）. Additionally， compared with the model group， the expression levels of IL-6， IL-1β and TNF-α in the Qingqiao and Laoqiao groups were significantly lower（P<0.01）. The chemical composition analysis of Qingqiao and Laoqiao revealed that 63 components were detected in Qingqiao and 55 components were detected in Laoqiao， with 47 common components， 16 components unique to Qingqiao and 8 components unique to Laoqiao. Characterizing the differences in serum metabolomics in rats， 19 and 12 metabolites were called back by Qingqiao and Laoqiao， respectively. The metabolic pathway enrichment analysis showed that Qingqiao exerted its therapeutic effects by affecting 6 key metabolic pathways， including linoleic acid metabolism， phenylalanine metabolism， phenylalanine， tyrosine and tryptophan biosynthesis， glycerophospholipid metabolism， α-linolenic acid metabolism， and arachidonic acid metabolism， and Laoqiao exerted therapeutic effects by affecting 6 key metabolic pathways， including linoleic acid metabolism， arachidonic acid metabolism， sphingolipid metabolism， phenylalanine metabolism， ascorbate and aldarate metabolism， and glycerophospholipid metabolism. ConclusionQingqiao and Laoqiao have therapeutic effects on ALI， and Qingqiao is more effective. Both of them can play a therapeutic role in ALI by regulating amino acid metabolism and lipid metabolism， but the metabolic pathways affected by them are different.